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Clinical pathways in hip and knee arthroplasty: a prospective randomised controlled study
Author(s) -
Dawsey Michelle M,
Kilgour Meredith L,
Santamaria Nick M,
Choong Peter F M
Publication year - 1999
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1999.tb126882.x
Subject(s) - medicine , clinical pathway , arthroplasty , prospective cohort study , referral , physical therapy , clinical trial , hip arthroplasty , tertiary referral hospital , randomized controlled trial , care pathway , surgery , health care , retrospective cohort study , nursing , family medicine , economics , economic growth
Objective To ascertain the effectiveness of clinical pathways for improving patient outcomes and decreasing lengths of stay after hip and knee arthroplasty. Design and setting Twelve‐month randomised prospective trial comparing patients treated through a clinical pathway with those treated by an established standard of care at a single tertiary referral university hospital. Participants 163 patients (56 men and 107 women; mean age, 66 years) undergoing primary hip or knee arthroplasty, and randomly allocated to the clinical pathway (92 patients) and the control group (71 patients). Main outcome measures Time to sitting out of bed and walking; rates of complications and readmissions; match to planned discharge destination; and length of hospital stay. Results Clinical pathway patients had a shorter mean length of stay (P=0.011), earlier ambulation(P=0.001), a lower readmission rate (P=0.06) and closer matching of discharge destination. There were beneficial effects of attending patient seminars and preadmission clinics for both pathway and control patients. Conclusion Clinical pathway is an effective method of improving patient outcomes and decreasing length of stay following hip and knee arthroplasty.