A clinical-care pathway for decreasing hospital stay after radical prostatectomy

British Journal of Urology
D W Keetch, D Buback

Abstract

To evaluate the use of a clinical-care pathway that decreased the stay in hospital after radical retropubic prostatectomy from 3 to 2 days, assessing the costs and quality of care. Forty-four consecutive men who underwent radical retropubic prostatectomy were evaluated prospectively. The first 22 men were hospitalized under the standard 3-day clinical-care pathway in use at our institution. This pathway was evaluated, shortened to construct a 2-day pathway, and a second group of 22 consecutive men hospitalized under the new pathway. Both groups were evaluated and compared 6 weeks post-operatively. The mean (SD) hospital stay was 2.1 (0.3) days for men in the 2-day and 2.9 (0.4) days for men in the 3-day pathway (P < 0.001). The mean (SD) hospital cost was $8468 (801) in the 2-day and $8806 (630) in the 3-day pathway (P=0.13). None of the men in the 2-day and one of 22 men in the 3-day pathway experienced a major complication (P=0.31). Two of 22 men in the 2-day and one of 22 in the 3-day pathway exceeded the expected stay by one day (P=0.55). The hospital stay after radical retropubic prostatectomy can be safely shortened from 3 to 2 days for most men. However, the shorter hospital stay does not result in significant cost savin...Continue Reading

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