Orient J M, Kettel L J, Sox H C, Sox C H, Berggren H J, Woods A H, Brown B W, Lebowitz M
Med Care. 1983 Feb;21(2):157-67. doi: 10.1097/00005650-198302000-00004.
In a Veterans Administration ambulatory care facility staffed by experienced nurse practitioners, we observed the length of visits, time utilization for various activities, and the use of diagnostic tests before and after introducing algorithms for 12 common chief complaints. Charges for diagnostic tests decreased as much as 40 per cent, primarily because of reduced utilization of radiographs such as spine films. Nurse practitioner productivity was unaffected once the nurse practitioners became familiar with the algorithms. Outcome of illness did not change measurably, but the process of care improved as reflected by more complete data collection documented in the medical record.
在一家由经验丰富的执业护士提供服务的退伍军人管理局门诊护理机构中，我们观察了引入针对12种常见主诉的算法前后的就诊时长、各项活动的时间利用情况以及诊断测试的使用情况。诊断测试费用下降了多达40%，主要原因是脊柱X光片等X光检查的使用减少。一旦执业护士熟悉了这些算法，他们的工作效率并未受到影响。疾病的治疗结果没有明显变化，但护理过程有所改善，病历中记录的资料收集更加完整就反映了这一点。
