The Journal of reproductive medicine · 2002
Improving treatment outcomes with a clinical pathway for hysterectomy and myomectomy.
Оценочное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Broder Michael S, Bovone Suzanne
Аннотация
OBJECTIVE: To determine if using a postoperative clinical pathway for women having hysterectomy or myomectomy would improve clinical care.
STUDY DESIGN: Data from the literature and patient focus groups guided development of a clinical pathway. Nurses, pharmacists and physicians participated in the development process. Implementation relied on accepted quality improvement methods. We used a case-control design to compare administrative and clinical data for patients managed with (n = 28) and without (n = 28) the aid of the clinical pathway between June 1997 and January 1998.
RESULTS: Case and control groups did not differ in age, race, payer status, severity of illness or procedure type. Clinical differences between pathway and nonpathway patients included a mean six-hour-shorter period of indwelling bladder catheters (P = .019), mean 11-hour more rapid return to regular diet (P = .014) and more pain assessments among pathway patients (mean, five vs. two; P < .001). There was no significant difference in length of stay between groups. Clinicians used the pathway for approximately one year, but with personnel changes the pathway gradually fell out of use.
CONCLUSION: Clinical pathways can improve quality of care, even if they do not reduce length of stay. A team approach that focuses on patient concerns during pathway development may help ensure that quality improvement, rather than simply cost reduction, arises from the use of clinical pathways.
STUDY DESIGN: Data from the literature and patient focus groups guided development of a clinical pathway. Nurses, pharmacists and physicians participated in the development process. Implementation relied on accepted quality improvement methods. We used a case-control design to compare administrative and clinical data for patients managed with (n = 28) and without (n = 28) the aid of the clinical pathway between June 1997 and January 1998.
RESULTS: Case and control groups did not differ in age, race, payer status, severity of illness or procedure type. Clinical differences between pathway and nonpathway patients included a mean six-hour-shorter period of indwelling bladder catheters (P = .019), mean 11-hour more rapid return to regular diet (P = .014) and more pain assessments among pathway patients (mean, five vs. two; P < .001). There was no significant difference in length of stay between groups. Clinicians used the pathway for approximately one year, but with personnel changes the pathway gradually fell out of use.
CONCLUSION: Clinical pathways can improve quality of care, even if they do not reduce length of stay. A team approach that focuses on patient concerns during pathway development may help ensure that quality improvement, rather than simply cost reduction, arises from the use of clinical pathways.