Study of arborizing clinical pathway in pediatric intussusceptions and appendicitis / 中华医院管理杂志

ABSTRACT

Objective To evaluate the feasibility and efficacy of a self-made arborizing clinical pathway( ACP ) in acute pediatric intussusceptions and appendicitis. Methods Based on the clinical pathway(CP)-node concept, an ACP electronic template with some CP branches for dealing with significant variations was made, using a doctor-advices package in the CP program of the Clinical Information System in our hospital. From February 2018 through January 2019, children inpatients diagnosed with acute intussusceptions at our hospital accepted the ACP or the conventional CP management respectively according to parity of admitted order. Results 426 children diagnosed with intussusceptions and 612 children diagnosed with appendicitis were included. After excluding some unqualified samples, 216 intussusception and 302 appendicitis children were enrolled in the observation group respectively which was subject to the ACP, 210 and 310 in the control group subject to the conventional CP. There were no significant differences between the observation and control groups in both diseases about patient demographics and therapeutic approach. The CP implementation-quality differences between the two groups in both diseases were observed and compared. Significant differences were found between the two groups in both diseases about CP completion rate(97.2% versus 90.5% and 97.7% versus 90.1% ), the rate of outside-CP doctor′s orders ((4.6 ± 1.3)% versus (19.3 ± 5.3)% and ( 6.1 ± 1.7 )% versus (20.3 ± 5.1 )% ), the hospitalized period((2.7 ± 0.3)d versus (3.2 ± 0.4)d and(5.6 ± 0.4) d versus (6.2 ± 0.5) d), the hospitalization costs and the satisfaction rate.Conclusions ACP belongs to one of compound CPs, is appropriate to use in these solitary diseases with significant variations. ACP can deal with the CP problem of significant variations rooted in the diseases or treatments, thus contributing to promotion and application of CP.