Web-based clinical pathway for reducing practice variations in radical prostatectomy.

BACKGROUND A clinical pathway support system on the Internet (CPSSI) has been designed for creating and implementing a web-based clinical pathway for radical prostatectomy. This investigation assessed the effects of the web-based clinical pathway for radical prostatectomy on practice variations. METHODS From June 2002 to Jun 2003, 22 consecutive patients with localized prostate cancer who underwent radical prostatectomy were treated according to the web-based clinical pathway. The treatment results were compared with an identically sized sample of patients treated during the year before implementing the web-based clinical pathway. Variations before and following the implementation of the web-based clinical pathway for radical prostatectomy were also assessed. The CPSSI automatically measured pathway variations and length of hospital stay. RESULTS After implementing the web-based clinical pathway, the average hospital stay was reduced significantly (p=0.0001). The mean number of variations also differed markedly (p=0.0002). CONCLUSION This study concludes that the CPSSI-based clinical pathway support system may provide a good tool for creating and implementing a web-based clinical pathway. After implementing the web-based clinical pathway for radical prostatectomy, practice variations and length of stay were reduced considerably. Moreover, automatically assessing the effects of web-based clinical pathway implementation can enhance the quality of patient care.