Morris M, Jameson S, Murdock S, Hohn D C
Medical Informatics, Houston, TX, USA.
Best Pract Benchmarking Healthc. 1996 May-Jun;1(3):118-25.
With the advent of managed care, academic medical centers have been challenged to lower costs and to document their claims of high quality outcomes. A successful method to achieve these objectives must not interfere with the academic missions of research and teaching. At M. D. Anderson Cancer Center, we initiated a program that would reduce practice variability and increase quality with a model that was familiar to the faculty.
Professional staff members were divided into disease site groups that included physicians, nurses, and other allied health staff. Each group developed practice guidelines and Collaborative Care Paths, based on evidence in the publications and on expert opinion. Desired outcomes were prospectively defined during this process. Before implementation, paths and guidelines underwent peer review.
The faculty actively participated in the development and implementation of the program that was viewed as a means of empowerment to deal with managed care. Nearly 1000 patients have been entered on the B8 paths that have been implemented to date.
A physician-driven outcomes management program permits delivery of high quality care and supports outcomes research while decreasing cost in an academic setting.
随着管理式医疗的出现，学术医疗中心面临着降低成本并证明其高质量医疗成果主张的挑战。实现这些目标的成功方法绝不能干扰研究和教学的学术使命。在MD安德森癌症中心，我们启动了一个项目，该项目将通过一种教职员工熟悉的模式来减少医疗实践的差异并提高质量。
专业工作人员被分成疾病部位小组，其中包括医生、护士和其他专职医护人员。每个小组根据出版物中的证据和专家意见制定了医疗实践指南和协作护理路径。在此过程中预先确定了期望的结果。在实施之前，路径和指南经过了同行评审。
教职员工积极参与了该项目的开发和实施，该项目被视为应对管理式医疗的一种赋权手段。迄今为止，已有近1000名患者进入了已实施的B8路径。
由医生驱动的医疗成果管理项目能够在学术环境中提供高质量医疗服务、支持医疗成果研究，同时降低成本。
