PubMed · 10154974
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J Morrissey. 1996-03-11. Software helps find critical pathways.. https://pubmed.ncbi.nlm.nih.gov/10154974/
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Critical Path (CP) is a kind of time-task matrix format. The first CP was developed by Karen Zander, an American nurse. The principal purpose of CP development was to improve the efficiency of hospital services under financial constraint caused by the introduction of DRG/PPS (Diagnosis Related Groups/Prospective payment system). Actually, the Japanese government is also discussing the possibility of introducing the DRG/PPS into the hospital financing scheme. In order to maintain, and even to improve the quality of hospital care, it is necessary to standardize care in the hospital. Thus it is necessary to develop a series of CPs in each hospital. In the spring of 1999, Prof. Osato, Director of the University Hospital, University of Occupational and Environmental Health, organized a task force team for CP development. Since then, this task force has been in charge of developing CP in our University Hospital. We have already developed several CPs and some of them are now in the process of field testing in each ward in order to check their applicability and problems to be corrected. In order to facilitate the use of CP in the hospital, doctors, nurses, pharmacists, and other health professionals must become more aware of the benefits of CP.
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Many interventions reduce stroke risk. However, the full benefits of these interventions are not realized at current levels of utilization, as nearly all evidence-based or guideline-endorsed stroke prevention services are underused. The cause for such underuse is multifactorial and includes factors relating to both patients and providers, as well as to a health care system that has de-emphasized prevention at the expense of acute, technologically based care. Much like the evidence for stroke interventions themselves, there is a growing literature to support methods of implementing research evidence into clinical practice. There is still much to learn, however, about the effectiveness of interventions aimed at achieving changes in stroke prevention practice or the delivery of stroke prevention care. Nevertheless, there are many opportunities for providers, managed care organizations, and government to close the evidence-practice gap that exists for stroke prevention services. These opportunities exist in both the inpatient and outpatient setting, and depend on the neurologist taking a leading role in emphasizing the critical importance of risk factor identification and modification in all patients at risk for stroke.