Department of Health Services Research, Institute of Psychology, Health and Society, Room 113, Block B, Waterhouse Building, Liverpool University School of Dentistry, Liverpool, L69 3GL, UK.
Br Dent J. 2011 Dec 9;211(11):E22. doi: 10.1038/sj.bdj.2011.1005.
Care pathways have been used in a variety of ways: firstly to support quality improvement through standardising clinical processes, but also for secondary purposes, by purchasers of healthcare, to monitor activity and health outcomes and to commission services. This paper focuses on reporting a secondary use of care pathways: to commission and monitor performance of primary dental care services. Findings of a project involving three dental practices implementing a system based on rating patients according to their risk of disease and need for care are outlined. Data from surgery-based clinical databases and interviews from commissioners and providers are reported. The use of both process and outcome key performance indicators in this context is discussed, as well as issues which arise such as attributability of outcome measures and strategic approaches to improving quality of care.
首先，通过标准化临床流程来支持质量改进，但医疗保健购买者也出于次要目的使用护理路径来监测活动和健康结果，并委托服务。本文重点介绍护理路径的次要用途：委托和监测初级牙科保健服务的绩效。本文概述了一个涉及三个牙科诊所实施基于疾病风险和护理需求对患者进行评分的系统的项目的结果。报告了基于手术的临床数据库的数据以及来自委托人和提供者的访谈。本文讨论了在这种情况下使用过程和结果关键绩效指标的问题，以及出现的问题，例如结果衡量的归因和提高护理质量的战略方法。
