improvement
Acute Pancreatitis (AP)

Last Update: October 2007

Contact: Laurel Despins, MS, APRN, BC, CCRN at (573) 884-6708

Summary:

Although acute pancreatitis is relatively rare, if not treated properly, it can be fatal or result in a prolonged and extremely uncomfortable illness for the patient. Nationally, one in 10 people with acute pancreatitis die from the disease.

In the medical field, the length of hospital stay is often used for measuring quality of care when other more sensitive clinical measures are either not collected or not available. Reducing variability in processes of care may reduce average length of stay. UMHSC average length of hospital stay was more than two days longer than the best performing University Hospital for this disease in 1996. Since acute pancreatitis is primarily an inpatient diagnosis, data is readily available through billing records.

The Office of Clinical Effectiveness reviewed data relevant to acute pancreatitis and determined there was an excellent opportunity for improvement based upon both administrative data and scientific literature. Though acute pancreatitis has been studied for more than 40 years, there was not a single source in the literature that directed clinicians to the most effective care and management of these patients.

The team decided that providing clinicians with one source of credible, evidenced-based information at the time when it was most urgently needed (admission to the emergency room or hospital with severe abdominal pain) was the single best intervention for patients with pancreatitis. It was critical to assure that the guideline reached the patient's chart at the time the physician confirmed the diagnosis of acute pancreatitis.

In addition to providing guidelines to physicians in a "just-in-time" fashion, our systematic review of the literature revealed that daily assessments of clinical severity are the single most important intervention needed to reduce morbidity and mortality among patients with acute pancreatitis. Thus, by helping physicians perform accurate severity assessments with the aid of an evidence-based guideline, improved patient outcomes were achieved.