PRIMARY SURVEY
Primary survey
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Pathway bundles can make a difference
This study, set in a medium sized district general hospital, found that for patients aged over 17 years with 2 or fewer diagnoses, the use of pathway bundles led to increased bed usage and improved length of stay when used from November 2006 to January 2007. The authors found that patients with acute coronary syndrome (ACS) and ST elevation myocardial infarction (STEMI) had reduced length of stay irrespective of their age and comorbidity. In individual disease-specific pathways, length of stay was reduced not only in ACS and STEMI but also sepsis, unlikely MI and upper GI bleed (in those with 2 or fewer diagnoses). Overall, in the group of patients with 2 or fewer diagnosis, up to 5.9 beds could be saved per day, an improvement by 2.5% (CI 0.25% to 4.38%) in medical bed usage. The authors intend to repeat the study to ensure that the effects are sustained
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