J Korean Neurosurg Soc.  2012 Jun;51(6):338-342. 10.3340/jkns.2012.51.6.338.

Implementation and Outcomes of a Critical Pathway for Lumbar Laminectomy or Microdiscectomy

• Chung SB
• Lee SH
• Kim ES
• Eoh W

• KMID: 2190487
• DOI: http://doi.org/10.3340/jkns.2012.51.6.338

Abstract

OBJECTIVE
The aim of this study is to implement a critical pathway (CP) for patients undergoing lumbar laminectomy or microdiscectomy and describe the results before and after the CP in terms of length of hospital stay and cost.
METHODS
From March 2008 to February 2009, 61 patients underwent lumbar laminectomy or microdiscectomy due to stenosis or one- or two-level disc herniation in our department and were included in the prepathway group. After development and implementation of the CP in March 2009, 58 patients were applicable for the CP, and these were classified as the postpathway group.
RESULTS
The CP, which established a 6-day hospital stay (5 bed-days), was fulfilled by 42 patients (72.4%) in the postpathway group. The mean length of stay was 5.4 days in the postpathway group compared to 6.9 days in the prepathway group, demonstrating a 20% reduction, which was a statistically significant difference (p< or =0.000). There was a statistically significant reduction in charges for bed and nursing care (p=0.002).
CONCLUSION
Implementation of a CP for lumbar laminectomy or microdiscectomy produced significant decreases in length of hospitalization and charges for bed and nursing care. We believe that this CP reduces the unnecessary use of hospital resources without increasing risk of adverse events.

Keyword

Critical pathway; Clinical pathways; Laminectomy; Microdiscectomy

MeSH Terms

Constriction, Pathologic
Critical Pathways
Fees and Charges
Hospitalization
Humans
Laminectomy
Length of Stay
Nursing Care

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