| 特集名 | ［特集］腎不全医療におけるクリニカルパスの再考 | |
|---|---|---|
| 題名 | クリニカルパスと医療の質・標準化の評価 (2) クリニカルパス導入から成熟へ向けて -- 紙ベースパスから電子パスへ | |
| 発刊年月 | 2005年 03月 | |
| 著者 | 林 靖子 | 福井赤十字病院クリニカルパス部会看護部 |
| 著者 | 渡辺 速美 | 福井赤十字病院病歴管理課・診療録管理士 |
| 著者 | 吉田 博之 | 福井赤十字病院循環器科 |
| 著者 | 野口 正人 | 福井赤十字病院放射線科，病院長 |
| 【 要旨 】 | 最近の医療政策のなかで，入院診療計画書の充実や急性期病院の在院日数の短縮などが重要になり，クリニカルパスは病院にとって不可欠なツールになっている．福井赤十字病院では1999年よりパス導入を行い，2002年から「適応基準」「除外基準」，「中間アウトカム」「退院アウトカム」を明記して，パスの改善を行った．そして，2005年には電子パスを稼動予定である． パス導入には院長の意志決定，強固な推進委員会，優秀な事務局の3要素が必要で，院内医療のパス化，次いでパスの改善を行う段階的導入が良いと考える．当院では現在，パスの電子化に向けて，使いやすいパス画面の作成を目標に，アウトカム設定，バリアンス評価の見直しを行っている． |
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| Theme | Revisit of Clinical Path in Renal Replacement Therapy | |
|---|---|---|
| Title | Implementation and improvement of clinical pathway | |
| Author | Yasuko Hayashi | Department of Nursing, Fukui Red Cross Hospital |
| Author | Hayami Watanabe | Department of Medical Record Library, Fukui Red Cross Hospital |
| Author | Hiroyuki Yoshida | Department of Cardiology, Fukui Red Cross Hospital |
| Author | Masato Noguchi | Department of Radiology, Hospital Director, Fukui Red Cross Hospital |
| [ Summary ] | Clinical pathways have become an indispensable tool for many Japanese hospitals. This is due to the revision of the medical payment system, which currently covers the enhancement of hospitalization and medical care plans, the reduction of hospital days at acute hospitals, etc. At Fukui Red Cross Hospital, we first implemented clinical pathways in 1998, freely adapting them to in-hospital situations in the early phase of implementation. We established promotion committees, composed of all divisions and departments in our hospital, under the supervision of the hospital director. After 2002, we defined the “indication criteria” and the “exclusion criteria” more distinctly. This led to clear indications of “mid-term outcome” and “hospital discharge outcome”, by which we realized the essential form of clinical pathways. Since January 2005, we have been planning to implement electronic clinical pathways. At our hospital, clinical pathways were implemented gradually. We believe that it is necessary to employ a method that may be fully adapted to each facility for the implementation and improvement of clinical pathways. |
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