Impact of a Clinical Pathway for Pediatric Uncomplicated Acute Appendicitis

Abstract

Abstract PurposeClinical Pathway (CP) for Pediatric Acute appendicitis (AP) was implemented in our institution to improve healthcare delivery, lessen hospital costs and decrease complications. AP remains to be one of the most common surgical procedure throughout the world. We present our results comparing outcomes before pathway and after pathway implementation.Methods.This is a time-series study in which data of all patients who underwent appendectomies done one year before the pathway implementation (prepathway) and a year after (pathway) were collected.Results.Eighty-seven (87) cases were included (47 prepathway vs 40 pathway). The pathway group had a decreased average length of stay (4.13 vs 2.95 days, p = 0.000) with improved antibiotic timing (80 vs 53 minutes, p = 0.000). There was a decreasing trend in monthly cost per procedure but not statistical significant (Philippine peso 1977 vs 620.91, p = 0.323) after pathway implementation. Other outcomes were SSI rate (12.7 vs 2.5%, p = 0.081), negative appendectomy rate (14.9 vs 7.5%, p = 0.284), readmission (0 vs 2.5%, p = 0.278), time-to-appendectomy (5 hours, 8 minutes vs 4 hours, 25 minutes, p = 0.180).Conclusion.Since CP implementation, we have improved our healthcare delivery indicators for pediatric AP. We recommend CP use by other institution tailored to specific needs in their patients.