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. 2016 May;142(5):1079-89.
doi: 10.1007/s00432-015-2106-z. Epub 2016 Jan 13.

Evaluating the effect of clinical care pathways on quality of cancer care: analysis of breast, colon and rectal cancer pathways

Han Bao  1 , Fengjuan Yang  1 , Shaofei Su  1 , Xinyu Wang  1 , Meiqi Zhang  1 , Yaming Xiao  1 , Hao Jiang  1 , Jiaying Wang  1 , Meina Liu  2
Affiliations

Evaluating the effect of clinical care pathways on quality of cancer care: analysis of breast, colon and rectal cancer pathways

Han Bao et al. J Cancer Res Clin Oncol. 2016 May.

Abstract

Purpose: Substantial gaps exist between clinical practice and evidence-based cancer care, potentially leading to adverse clinical outcomes and decreased quality of life for cancer patients. This study aimed to evaluate the usefulness of clinical pathways as a tool for improving quality of cancer care, using breast, colon, and rectal cancer pathways as demonstrations.

Methods: Newly diagnosed patients with invasive breast, colon, and rectal cancer were enrolled as pre-pathway groups, while patients with the same diagnoses treated according to clinical pathways were recruited for post-pathway groups.

Results: Compliance with preoperative core biopsy or fine-needle aspiration, utilization of sentinel lymph node biopsy, and proportion of patients whose tumor hormone receptor status was stated in pathology report were significantly increased after implementation of clinical pathway for breast cancer. For colon cancer, compliance with two care processes was significantly improved: surgical resection with anastomosis and resection of at least 12 lymph nodes. Regarding rectal cancer, there was a significant increase in compliance with preoperative evaluation of depth of tumor invasion, total mesorectal excision treatment of middle- or low-position rectal cancer, and proportion of patients who had undergone rectal cancer surgery whose pathology report included margin status. Moreover, total length of hospital stay was decreased remarkably for all three cancer types, and postoperative complications remained unchanged following implementation of the clinical pathways.

Conclusions: Clinical pathways can improve compliance with standard care by implementing evidence-based quality indicators in daily practice, which could serve as a useful tool for narrowing the gap between clinical practice and evidence-based care.

Keywords: Cancer; Clinical pathway; Quality improvement; Quality of care.

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Conflict of interest statement

We declare that we have no conflict of interest.

Figures

Fig. 1
Fig. 1
Total length of hospital stay (days) for the three cancer types
Fig. 2
Fig. 2
Preoperative length of hospital stay (days) for the three cancer types
See this image and copyright information in PMC

References

    1. Aeyels D, Van Vugt S, Sinnaeve PR, Panella M, Van Zelm R, Sermeus W, Vanhaecht K (2015) Lack of evidence and standardization in care pathway documents for patients with ST-elevated myocardial infarction. Eur J Cardiovasc Nurs. doi:10.1177/1474515115580237 - PubMed
    1. Badakhshi H, Gruen A, Sehouli J, Budach V, Boehmer D (2013) The impact of patient compliance with adjuvant radiotherapy: a comprehensive cohort study. Cancer Med 2:712–717 - PMC - PubMed
    1. Bao H, Yang FJ, Wang XY, Su SF, Liu D, Fu R, Zhang HM, Liu MN (2015) Developing a set of quality indicators for breast cancer care in China. Int J Qual Health Care 27:291–296 - DOI - PubMed
    1. Beaupre LA, Cinats JG, Senthilselvan A, Lier D, Jones CA, Scharfenberger A, Johnston DW, Saunders LD (2006) Reduced morbidity for elderly patients with a hip fracture after implementation of a perioperative evidence-based clinical pathway. Qual Saf Health Care 15:375–379 - DOI - PMC - PubMed
    1. Bernardshaw SV, Øvrebø K, Eide GE, Skarstein A, Røkke O (2006) Treatment of rectal cancer: reduction of local recurrence after the introduction of TME—experience from One University Hospital. Dig Surg 23:51–59 - DOI - PubMed

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