Thyroid tumor clinical path

Abstract

The need for improved medical treatment quality, efficient use of medical finances, and shortening of hospitalization have helped disseminate team medical care using a clinical path. In otorhinolaryngological head and neck surgery, medical facilities have created a clinical path for tonsillectomy, tympanoplasty, and radical sinus maxilectomy and ethmoidectomy. Such a path has not been made, however, for head and neck tumors. We created a clinical for thyroid tumor, then evaluated its advantages and disadvantages. We started the clinical path for benign thyroid tumors in April 2000 for 14 thyroid tumor patients considered benign before surgery. In some cases, the clinical path was slightly changed to allow for delayed drain extraction or increasing the number of blood pressure measurements due to complications of hypertension. No variation was so major, however, that the clinical path had to be canceled. Its advantages were (1) average hospitalization shortened from 18.7 days to 14.5 days, and (2) the clinical path was useful for educating new staff. Since changes are more likely to occur in cases of tumors, medical staff and patients must understand that the clinical path basically represents the standard or average and may depend greatly on the individual condition. Since the clinical path represents the standard or average at a certain time point, it must be revised. A clinical path is, even so, useful in the treatment of tumor.