Miracle P, Savage T, Hickey T, Mountjoy B, Martin P A
Miami Valley Hospital, Dayton, Ohio 45409, USA.
Nurs Case Manag. 1998 Jul-Aug;3(4):160-7.
The authors describe the development of critical pathways for ambulatory obstetric case management. When case management was identified as needed, but published work in outpatient obstetrics could not be found, four nurses used this opportunity to design a cost-effective system leading to quality outcomes. The driving force was the need for a format that directed comprehensive consistent care delivered by a large multidisciplinary health care team. Design issues included capturing leading edge standards of care and user friendly formats for all caregivers. Throughout a period of 2 years, a trifold format was developed for all obstetric patients, and 15 bifold formats were developed for patients with specific high-risk diagnoses. The format design facilitated cost-effective quality care and is expected to improve patient outcomes. A research study has been initiated to measure effectiveness of the design.
作者描述了门诊产科病例管理关键路径的制定过程。当确定需要进行病例管理，但在门诊产科领域找不到已发表的相关工作时，四名护士利用这个机会设计了一个具有成本效益的系统，以实现优质的治疗效果。推动这一工作的动力是需要一种能指导大型多学科医疗团队提供全面、一致护理的模式。设计问题包括采用前沿的护理标准以及为所有护理人员设计用户友好的模式。在两年的时间里，为所有产科患者开发了一种三折页模式，为患有特定高危诊断的患者开发了15种双折页模式。这种模式设计促进了具有成本效益的优质护理，并有望改善患者的治疗效果。目前已启动一项研究，以评估该设计的有效性。
