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Clinical pathway for abbreviated postoperative hospital stay in free tissue transfer to the head and neck: Impact in resource utilization and surgical outcomes
- Source :
- Headneck. 41(4)
- Publication Year :
- 2017
-
Abstract
- Background Assess the impact of a clinical pathway and progressive care unit (CPW/PCU) for patients undergoing head and neck free flap reconstruction with regard to patient outcomes and resource utilization. Methods Retrospective chart review of 270 patients at an academic tertiary-care center (2009-2014). Outcomes were compared among a control, CPW/PCU transition, and CPW/PCU groups. Results Compared to control, the CPW/PCU group had significantly reduced medical complications (21.1%-4.1%), intensive care unit length of stay (LOS, 5.02-0.2 days), hospital LOS (10.5-6.2 days), standardized total charges ($88 270-$58 661), and hospital costs ($41 365-$22 680). There were no observed differences in flap viability, surgical complications, reoperations, or readmissions. The CPW/PCU group achieved 100% home discharge. Conclusions Our proposed CPW significantly improved patient outcomes and reduced resource utilization while maintaining flap outcomes. We propose a dynamic model for resource allocation that is easily reproducible in both academic and nonacademic settings.
- Subjects :
- Graft Rejection
Male
medicine.medical_specialty
Databases, Factual
Progressive care unit
Free Tissue Flaps
law.invention
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Clinical pathway
Postoperative Complications
law
Medicine
Humans
Hospital Costs
030223 otorhinolaryngology
Head and neck
Aged
Retrospective Studies
Postoperative Care
Academic Medical Centers
Analysis of Variance
business.industry
Graft Survival
Length of Stay
Middle Aged
Plastic Surgery Procedures
Prognosis
Intensive care unit
United States
Surgery
Tissue transfer
Treatment Outcome
Otorhinolaryngology
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Critical Pathways
Quality of Life
Free flap reconstruction
Health Resources
Neck Dissection
Female
business
Hospital stay
Resource utilization
Subjects
Details
- ISSN :
- 10970347
- Volume :
- 41
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Headneck
- Accession number :
- edsair.doi.dedup.....071258aea61bbab225b12c5848885fd6