Clinical pathways are similar to the production algorithms developed by industry. They are being adapted for use in healthcare to reduce resource utilization, decrease variability, and control expenditures. At Boston ...
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Clinical pathways are similar to the production algorithms developed by industry. They are being adapted for use in healthcare to reduce resource utilization, decrease variability, and control expenditures. At Boston Medical Center we identified four trauma diagnoses that we believed to be amenable to the design and implementation of clinical pathways: closed head injury, penetrating wound to the abdomen, penetrating wound to the chest, and penetrating wound to an extremity. Upon implementation of these pathways, appropriate nonoperative, single-system, short-stay trauma patients were enrolled in them. This article details the process by which the four diagnoses were identified and the pathways designed, implemented, and evaluated. Preliminary data demonstrate a significant decrease in resource utilization following implementation of the pathways, without an adverse impact on readmission rates, length of stay, or mortality.
Too often, systematic recording procedures are not developed which describe and assess the delivery of social work--and, more specifically, case management--services. The authors report on the Service Tracking and Ref...
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Too often, systematic recording procedures are not developed which describe and assess the delivery of social work--and, more specifically, case management--services. The authors report on the Service Tracking and Referral Form developed by California's Adolescent Family Life Evaluation Project to document the receipt of services by pregnant adolescent clients as a result of case management intervention. The rationale and process underlying the development and use of the project's Service Tracking and Referral Form are discussed. Data are presented to illustrate the kinds of information which can be generated from the form. Finally, the authors discuss the form's utility and the possible uses of these types of data for case management, supervisory, administrative, and evaluative purposes.
Preventing falls among hospitalized patients continues to be a major concern of nurses, as evidenced by the volume of literature on this subject during the past 10 years. Yet, preventing falls, like preventing medicat...
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Preventing falls among hospitalized patients continues to be a major concern of nurses, as evidenced by the volume of literature on this subject during the past 10 years. Yet, preventing falls, like preventing medication errors, has been a difficult and chronic issue for most nursing departments. Carolyn Corbett and Barbara Pennypacker describe how the nursing staff at Robert Packer Hospital in Sayre, PA, finally has experienced success by applying the systematic methods and principles of continuous quality improvement and establishing a fall prevention process.
The quality of patient care services provided by individuals not subject to the medical staff privilege delineation process must be evaluated. With the advent of total quality management, the food and nutrition servic...
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The quality of patient care services provided by individuals not subject to the medical staff privilege delineation process must be evaluated. With the advent of total quality management, the food and nutrition services department at Walter Reuther Psychiatric Hospital in Westland, MI, has begun using a quality assessment system that simplifies and improves the objectivity of the performance appraisal process while providing valuable data for improving the quality of patient care.
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