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Clinical Pathway Discloses One Surgeon's $425 Habit

Clinical Pathway Discloses One Surgeon's $425 Habit

PHILADELPHIA--When practice guidelines or pathways take financial considerations into account, they may be termed clinical financial pathways (CFPs). This technique was developed by Kent Giles, MPPM, vice president of development at PhyMatrix, a physician management company headquartered in West Palm Beach, Fla, and is currently being utilized by PhyMatrix to reduce unnecessary medical costs.

Developing CFPs involves seven steps, Mr. Giles said at the Association of Cancer Executives meeting (see also page 20): Select a disease process, form a knowledgeable team, clarify the current state of medical knowledge, develop the pathway, assign costs to each process, implement the pathway, and monitor the results.

During development of the prostate CFP, he said, the team found that one urologist was using three surgical trays per radical prostatectomy to access the three instruments he needed, since the hospital routinely placed only one of these instruments on the surgical tray.

This practice, which added $425 in unnecessary costs for extra sterilization and wasted anesthesiologist and surgeon time, was eliminated with implementation of the CFP, and the patient's time under anesthesia was reduced by 30 minutes, ie, a quality enhancement.

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