Tidwell S L
Cardiothoracic Surgery X3-CAR, Virginia Mason Medical Center, Seattle, Washington 98111.
Prog Cardiovasc Nurs. 1993 Fall;8(2):6-19.
Nursing case management has been documented as one solution to the balance of cost and quality issues in healthcare. A current focus in healthcare is continuous quality improvement (CQI). CQI methods are focused on outcome measurements. Outcome research is a recent development in case management. Tracking variance, evaluating cost reduction and patient effectiveness, and determining types of patients at risk for negative variance are current case management research demands. Tracking patient comorbidities would allow for additional subset "tailoring" of existing critical pathways for specific comorbidities. Little research has been done on these issues. Few systems exist that track both variance and comorbidities. This article presents a graphic, simple, multidisciplinary tracking system that includes comorbidities and allows for individual and group patient variance analysis.
护理病例管理已被证明是解决医疗保健中成本与质量平衡问题的一种方法。当前医疗保健的一个重点是持续质量改进（CQI）。CQI方法侧重于结果测量。结果研究是病例管理领域的一项最新进展。跟踪差异、评估成本降低和患者疗效，以及确定存在负面差异风险的患者类型是当前病例管理研究的需求。跟踪患者的合并症将允许针对特定合并症对现有关键路径进行额外的子集“定制”。关于这些问题的研究很少。很少有系统能够同时跟踪差异和合并症。本文介绍了一种图形化、简单的多学科跟踪系统，该系统包括合并症，并允许对个体和群体患者的差异进行分析。
