Clinical pathways in general surgery. Development, implementation, and evaluation.

OBJECTIVES To emphasize the importance of the view of business process management for development and implementation of clinical pathways, and to evaluate their effectiveness in reducing cost and effort as well as enhancing patient satisfaction. METHODS We describe the development and implementation of pathways with methods of process management and the design and realization of an evaluation study in the setting of a surgical department. For this study 67 patients treated without clinical pathways were compared with 62 patients treated using pathways. RESULTS The approach explicitly enhances the development and implementation of clinical pathways. The introduction of pathways reduces length of hospital stay, number of laboratory tests, number of consultations, and number of imaging procedures. Patient satisfaction is improved. CONCLUSIONS Depending on design and setting, the introduction of clinical pathways may be a very promising method to improve the inpatient service at a hospital and so to react to the challenges of increasing competition in medical care.