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Clinical pathway management of total knee arthroplasty: a retrospective comparative study


Pearson, S and Moraw, I and Maddern, G, Clinical pathway management of total knee arthroplasty: a retrospective comparative study, The Australian and New Zealand journal of surgery, 70, (5) pp. 351-354. ISSN 0004-8682 (2000) [Refereed Article]

Copyright Statement

Copyright 2000 John Wiley & Sons, Inc.

DOI: doi:10.1046/j.1440-1622.2000.01819.x


BACKGROUND: Clinical pathways facilitate the management of defined patient groups using interdisciplinary plans of care. The aim of the present study was to evaluate the effectiveness of a clinical pathway in improving a range of selected outcome measures in patients who have undergone total knee arthroplasty (TKA). METHODS: The present study was conducted at Queen Elizabeth Hospital, Adelaide. Using a retrospective comparative study design, 119 TKA patients who were managed on a clinical pathway from July 1997 to January 1998 (group 2) were compared with a retrospective group of 58 patients who underwent the same procedure from July 1996 to January 1997 (group 1) prior to the pathway's implementation. The following outcomes were measured: length of hospital stay; postoperative complications; readmissions and emergency service visits within 6 months of discharge; day of transfer to the convalescent unit; convalescent unit utilization and admission and discharge times. RESULTS: There was a significant reduction in the median length of stay in group 2 patients (9 vs 7 days; P < 0.0001). In addition there was a 66% increase in the proportion of patients in group 2 who were admitted on the day of surgery (P < 0.0001) and a 19.6% increase in the number of patients discharged within 8 postoperative days (P < 0.01). There were no significant differences between the groups with respect to the occurrence of postoperative complications. Although there was a trend toward a reduction in emergency service utilization and readmissions within 6 months of discharge for patients managed on the pathway, this was not significant. CONCLUSIONS: The development and implementation of a TKA clinical pathway resulted in a significant reduction in length of stay and improved streamlining of admission, discharge and transfer processes without adversely affecting patient outcomes.

Item Details

Item Type:Refereed Article
Keywords:clinical pathways, knee replacement
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Primary health care
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Health status (incl. wellbeing)
UTAS Author:Pearson, S (Dr Sue Pearson)
ID Code:83238
Year Published:2000
Web of Science® Times Cited:44
Deposited By:Medicine
Deposited On:2013-03-06
Last Modified:2013-06-26

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