Development of a clinical pathway for total knee arthroplasty and the effect on length of stay and in-hospital functional outcome


Published online: Aug 27 2005

Kris VANHAECHT, Walter SERMEUS, Gerd TUERLINCKX, Ine WITTERS, Hilde VANDENNEUCKER, Johan BELLEMANS

From the Centre for Health Services and Nursing Research and The University Hospitals Pellenberg, Leuven, Belgium

Abstract

The goal of reducing the length of a patient's hospital stay after orthopaedic surgery has recently gained much interest from surgeons and hospital administrators. The influence of hospital stay reduction on qualitative outcome is not always documented. The purpose of this study was to investigate this relationship in more detail. We report our experience with patients undergoing total knee arthroplasty. In 2000, an in-hospital clinical pathway for patients undergoing total knee arthroplasty was instituted at the University Hospitals Pellenberg, Belgium. We evaluated this pathway in 103 patients by using a preexperimental, interrupted, time-series design. This pathway significantly decreased length of stay by 33% without negatively affecting functional outcomes during hospitalisation. In further research also the long term effects have to be studied.