Evaluation of a Clinical Pathway to Improve Colorectal Cancer Outcomes

Abstract

The aims of this preintervention and postintervention study were to monitor and evaluate the clinical pathway (CP) for colorectal cancer (CRC) over a 5-year period and to compare 2 groups of patients (before and after the intervention) with regard to different variables of effectiveness. Group I comprised 68 patients who underwent planned surgery between January 2002 and January 2003. Group II comprised a sample of 202 patients who underwent surgery between January 2004 and December 2008. No significant differences were found in the majority of the parameters measured: postoperative stay, compliance with antibiotic prophylaxis, compliance with the staging study, mortality, rate of infection, and reoperations. The mean length of stay (±standard deviation) for patients without complications was reduced significantly (9.2 ± 3.6 in group I versus 7.7 ± 1.7 in group II, P = .031). The CP for CRC did not achieve most of the objectives for which it was designed.

Integrated Care Planning for Cancer Patients: A Scoping Review

“…Patient/caregiver engagement by way of involving patients in generating the integrated care plan and accounting for patient (and/or caregiver preferences) featured prominently in plans focused on survivorship and palliative stages [ 43 59 62 63 78 ]. Some studies also reported allowing patients to access the integrated care plan through an electronic or paper format to enable patients to be actively engaged in treatment planning and delivery during their cancer journey [ 35 59 77 ].…”

“…Provider-level outcomes included provider satisfaction with the use of integrated care plans, i.e., workflow interruptions, ease of use, time associated with generating or discussing the integrated care plan with patients [ 74 83 ], and provider’s perceptions of benefits (i.e., improvements in information sharing between providers) [ 71 74 79 80 83 98 ]. System-level indicators included common healthcare utilization measures such as length of stay, complication rates (post-operative), hospital readmissions, and cost (hospital-related costs and the cost of delivering the integrated care plan) [ 36 39 40 41 43 46 47 48 49 51 54 55 56 57 58 60 61 67 85 95 ].…”

“…The adoption of an integrated care plan to guide the delivery of care relies heavily on provider uptake and training on how to use the integrated care plan [ 34 39 43 60 61 75 94 ]. The upstream involvement and continuous engagement of providers during plan development and evaluation were considered core elements of the design phase [ 38 39 60 ].…”

Effect of Development of Clinical Pathway on Post-operative complications for Colorectal Surgery Patients

“…Clinical pathway for colorectal carcinoma, this tool was developed by the researcher after extensive review of related literatures (Aledo, 2011) this tool was applied on the study group. It was used to measure the reliability of the developed tools.…”