The evaluation of acute appendicitis clinical Pathway

Introduction: Acute Appendicitis is the 1st emergency case for the abdominal disease in Indonesia. In 2014, Clinical Pathway is one of the requirements that must be met in the hospital’s accreditation standards. It is crucial for the hospital having a successful of implementation of clinical pathway as Indonesia run universal health coverage. As the 4th year of this regulation, all hospital needs to implement clinical pathway as a tool for variations control. Objects of this research are: 1) how is compliances in acute appendicitis management after using clinical pathway, 2) is clinical pathway successful as a tool to reduce variances. Method: This research used mix methods. A retrospective analysis of medical records (July 2016 - June 2017) was performed. The CP comprised the following indicators of compliance: doctor visit, laboratory tests, medication, anaesthesia consultation, technic of surgery and nutrition. In-depth interview was performed to those who involved in the implementation of CP by purposive sampling technique. Results: There were 35 patients of which 25 (71%) were female and 10 (29%) were male. The compliance to clinical pathway were 37% patient for length of stay (3 days), 29% patient in medication and laboratory tests, 36% patient in anaesthesia consultation, 94% in Open Appendectomy, 100% in doctor visits and nutrition. Conclusions: Compliance to CP of Acute Appendicitis was low especially in medication and laboratory tests. Clinical pathway is unsuccessful as a tool to reduce the variances.