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Clinical pathway reduces length of stay for outpatients electing PEG feeding tubes
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A clinical pathway for percutaneous endoscopic gastrostomy feeding tubes reduced outpatient length of stay, according to data presented at ASPEN Clinical Nutrition Week.
Researchers from the Cancer Treatment Centers of America in Philadelphia initiated a quality improvement project to create a clinical pathway for outpatients electing a percutaneous endoscopic gastrostomy (PEG) feeding tube to reduce longer inpatient stays caused by delays in insurance coverage arrangement for formula and supplies, and to improve patient education. The clinical pathway was designed to optimize staff communication, initiate insurance verification before tube placement and standardize patient education.
After implementation, they assessed the impact of this clinical pathway on patient length of stay by reviewing medical records for 24 patients who received an outpatient PEG feeding tube between 2013 and August 2014, stratifying data on length of stay before (n = 16) and after (n = 8) implementation in March 2014. Mean length of stay was 3.1 days (range, 1-9) for patients before implementation compared with 1 day (range, 0-3) after implementation, resulting in a 32% decrease in average length of stay (P = .005). They were unable to evaluate changes in efficacy of patient education; however, two patients after implementation felt comfortable enough with training and supplies that they opted out of the institution’s standard 23-hour observation period.
The researchers concluded that implementing this clinical pathway significantly reduced length of stay for outpatients electing a PEG feeding tube, saving an estimated $4,000 per patient. Future plans include refining the clinical pathway using patient surveys, and creating a clinical pathway for inpatient PEG feeding tube placement, they wrote. – by Adam Leitenberger
Reference:
Battish R, et al. Abstract S-40. Presented at: ASPEN Clinical Nutrition Week; Feb. 14-17, 2015; Long Beach, Calif.
Disclosure: The researchers report no relevant financial disclosures.