PubMed · 10162203
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M F McKinsey. Synchronized caring.. https://pubmed.ncbi.nlm.nih.gov/10162203/
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Critical pathways are widely adopted by many large hospitals around the world in order to provide high-quality patient treatment. The development of critical pathways is a lengthy process, and may require the collaboration among physicians, nurses, and staffs in a hospital. The development and implementation of critical pathways at Kanto Medical Center and the transition to a computerized multidisciplinary documentation system took place between 2000 and 2001. The article describes the process of creating the automated documentation system to support the critical pathways. The advantages, pitfalls learned in this integration experience are described.
In Japan there is a possibility that diagnosis related group/prospective payment system (DRG/PPS) will be introduced as one means to decrease medical expenses in the future. Recently, measures to improve medical services, including approaches to improving medical care represented by evidence based medicine (EBM) and disclosure of medical information including clinical records, have been seen. The authors department is attempting to introduce clinical paths as one tool to cope with such changes in medical care circumstances. Using the tabulations of patients over the past year and major diagnostic classification (MDC) with the Japanese edition of DRG/PPS serving as a guide, we have prepared critical paths for ten diagnosis and treatment groups consisting of sudden deafness, tonsillectomy, laryngo-microsurgery, endoscopic sinus surgery, tympanoplasty, removal of parotid gland tumor, neck dissection, total laryngectomy, total pharyngo-laryngectomy and operation for tongue-oropharyngeal cancer. We report herein on the present status of the introduction of these critical paths at our department.
We have introduced a critical path for esophagectomy of esophageal cancer from January, 2001 and got good results. It is important of the adaptation and the evaluation of variances for the critical path. Patients and co-medicals understood deeply the disease and the treatment of esophageal cancer. We could improvement the process of treatments by changing the critical path easily. We concluded that a critical path was adapted for esophagectomy of esophageal cancer, and it will be getting important.