PMID- 25553155
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20150101
LR  - 20220331
IS  - 1911-6470 (Print)
IS  - 1920-1214 (Electronic)
IS  - 1911-6470 (Linking)
VI  - 8
IP  - 11-12
DP  - 2014 Nov
TI  - Enhanced recovery pathway for radical prostatectomy: Implementation and 
      evaluation in a universal healthcare system.
PG  - 418-23
LID - 10.5489/cuaj.2114 [doi]
AB  - INTRODUCTION: Enhanced recovery pathways are standardized, multidisciplinary, 
      consensus-based tools that provide guidelines for evidence-based decision-making. 
      This study evaluates the impact of the implementation of a clinical care pathway 
      on patient outcomes following radical prostatectomy in a universal healthcare 
      system. METHODS: Medical charts of 200 patients with prostate cancer who 
      underwent open and minimally invasive radical prostatectomy at a single academic 
      hospital from 2009 to 2012 were reviewed. A group of 100 consecutive patients' 
      pre-pathway implementation was compared with 99 consecutive patients' 
      post-pathway implementation. Duration of hospital stay, complications, 
      post-discharge emergency department visits and readmissions were compared between 
      the 2 groups. RESULTS: Length of hospital stay decreased from a median of 3 
      (inter-quartile range [IQR] 4 to 3 days) days in the pre-pathway group to a 
      median of 2 (IQR 3 to 2 days) days in the post-pathway group regardless of 
      surgical approach (p < 0.0001). Complication rates, emergency department visits 
      and hospital readmissions were not significantly different in the pre- and 
      post-pathway groups (17% vs. 21%, p = 0.80; 12% vs. 12%, p = 0.95; and 3% vs. 7%, 
      p = 0.18, respectively). These findings were consistent after stratification by 
      surgical approach. Limitations of our study include lack of assessment of patient 
      satisfaction, and the retrospective study design. CONCLUSIONS: The implementation 
      of a standardized, multidisciplinary clinical care pathway for patients 
      undergoing radical prostatectomy improved efficiency without increasing 
      complication rates or hospital readmissions.
FAU - Abou-Haidar, Hiba
AU  - Abou-Haidar H
AD  - Faculty of Medicine, McGill University, Montreal, QC;
FAU - Abourbih, Samuel
AU  - Abourbih S
AD  - Department of Surgery (Urology), McGill University Health Centre, Montreal, QC;
FAU - Braganza, David
AU  - Braganza D
AD  - Faculty of Medicine, McGill University, Montreal, QC;
FAU - Qaoud, Talal Al
AU  - Qaoud TA
AD  - Department of Surgery (Urology), McGill University Health Centre, Montreal, QC;
FAU - Lee, Lawrence
AU  - Lee L
AD  - Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, 
      Department of Surgery, McGill University Health Centre, Montreal, QC;
FAU - Carli, Franco
AU  - Carli F
AD  - Department of Anesthesia, McGill University Health Centre, Montreal, QC;
FAU - Watson, Deborah
AU  - Watson D
AD  - Department of Nursing, McGill University Health Centre, Montreal, QC.
FAU - Aprikian, Armen G
AU  - Aprikian AG
AD  - Department of Surgery (Urology), McGill University Health Centre, Montreal, QC;
FAU - Tanguay, Simon
AU  - Tanguay S
AD  - Department of Surgery (Urology), McGill University Health Centre, Montreal, QC;
FAU - Feldman, Liane S
AU  - Feldman LS
AD  - Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, 
      Department of Surgery, McGill University Health Centre, Montreal, QC;
FAU - Kassouf, Wassim
AU  - Kassouf W
AD  - Department of Surgery (Urology), McGill University Health Centre, Montreal, QC;
LA  - eng
PT  - Journal Article
PL  - Canada
TA  - Can Urol Assoc J
JT  - Canadian Urological Association journal = Journal de l'Association des urologues 
      du Canada
JID - 101312644
PMC - PMC4277521
EDAT- 2015/01/02 06:00
MHDA- 2015/01/02 06:01
PMCR- 2014/11/01
CRDT- 2015/01/02 06:00
PHST- 2015/01/02 06:00 [entrez]
PHST- 2015/01/02 06:00 [pubmed]
PHST- 2015/01/02 06:01 [medline]
PHST- 2014/11/01 00:00 [pmc-release]
AID - cuaj-11-12-418 [pii]
AID - 10.5489/cuaj.2114 [doi]
PST - ppublish
SO  - Can Urol Assoc J. 2014 Nov;8(11-12):418-23. doi: 10.5489/cuaj.2114.