Borkowski V
St. Margaret Mercy Healthcare Centers, Dyer, IN.
J Healthc Qual. 1994 Mar-Apr;16(2):25-7, 30. doi: 10.1111/j.1945-1474.1994.tb00695.x.
The center of attention in recent nursing literature has been on the evolution of outcome-based care. This concept has emerged as an array of models that includes patient-focused care, case management, and managed care. All these approaches to redesigning patient care have a basic goal: to deliver quality care in a timely manner by using appropriate resources. The program at St. Margaret Mercy Healthcare Centers focused on the staff nurse as the multidisciplinary team member who would be responsible for coordinating patient care. This type of model, in which the pathway is initiated at the staff level, is called managed care. Managed care, as defined by Zander, is unit-based care that is organized to achieve specific patient outcomes within fiscally responsible time frames or lengths of stay (LOS) while using resources that are appropriate in amount and sequence to the specific case type and to the individual patient (1988a).
近期护理文献关注的焦点一直是基于结果的护理的演变。这一概念已发展成为一系列模式，包括以患者为中心的护理、病例管理和管理式护理。所有这些重新设计患者护理的方法都有一个基本目标：通过使用适当的资源及时提供优质护理。圣玛格丽特仁慈医疗中心的项目将重点放在作为多学科团队成员的注册护士身上，由其负责协调患者护理。这种在员工层面启动流程的模式被称为管理式护理。根据赞德的定义，管理式护理是以病房为基础的护理，其组织方式是在符合财务责任的时间框架或住院时长内实现特定的患者治疗结果，同时使用在数量和顺序上适合特定病例类型及个体患者的资源（1988a）。
