Care pathways in obstetrics: the effectiveness in reducing the incidence of episiotomy in childbirth

AIM: To develop a care pathway for childbirth. BACKGROUND: Care pathways are emerging as an effective tool to improve clinical and organizational performance. METHODS: A pre- and postimplementation analysis model was used to evaluate the effect of introducing a care pathway for childbirth. Key outcome indicators and costs were reviewed to compare the traditional care processes with those of the care pathway. The study involved 380 women. RESULTS: There was a significant reduction in episiotomy rate (from 14.90% to 8.6%, P = 0.02) in patients being cared for using a care pathway approach; however, there were no differences in caesarean section and in perineal wound rates. The average costs per patient on the care pathway were euro 1278.42 ( pound 873.64) compared with euro 1,146.87 ( pound 783.74) preimplementation. The study also demon- strated an increase in patient satisfaction for women cared for using the care pathway approach. CONCLUSIONS: The care pathway proved to be a valid methodological approach to childbirth, allowing healthcare workers to efficiently share the care of the women, guaranteeing safe and effective care.