We reported on the variance in cases which deviate from the critical path. Twenty-seven cases of cuff repair were treated with a critical path. Twenty were male and seven were female and their average age was 57.6 years old. We used the critical path in which patients had an abduction brace in sixteen cases and the critical path in which the patients had arm-sling in eleven. We examined two variance elements which were if outcome was achieved and how many days the patients stayed in hospital. All patients achieved outcome (patient improved their own symptoms before the operation and patient undersood the exercises after discharge). But there were fifteen cases of positive variance (early discharge) and twelve cases of negative variance (late discharge). Nine of the 15 negative variance patients delayed ther discharge from the hospital five days later than originally planned. From the point of element of variance (patient, medical staff, institute and social problem etc. ), the discharge of seven cases was delayed because of patient's physical conditions. Three were massive tear and two were large tear. Five patients had pain at the time of discharge and two patients lost their power because of a massive tear. In the positive variance five patients went back home more than five days earlier than the day they were supposed to be discharged. These five patients had a relatively small tear (1.8cm × 1.3cm in average) and had an arm sling after surgery. As a result, we changed critical paths. In the new critical path we can change the hospital days according to the size of the tear. Critical path is very useful for proper improvement of postoperative therapy which we did aimlessly until now and useful for proper hospital stays.
