Application Study Of The Clinical Pathway

With the deep reform of medical health care system and the pregressively sharp competition of medical market, hospitals can provide people with medical health services with low-price, good quality and high efficiency and survive prominently in the competitive medical market by the enhancement of control of medical quality, decreases in hospitalization cost and hopitalization time, saving of hygiene resources, improvement of the ratio of medical efficiency to cost.The author of this research project, based on the advanced experiences of foreign hospitals in the studies and application of clinical pathway, has conducted a systematic study of the flow design, organization and practice,process control,effects of application for the purpose of the exploration of the internal laws of clinical pathway so as to find the practical and feasible methods for the practice of clinical pathway in China.In this research project, retrospective method was adopted. With the aid of hospital information system(HIS), we retrieved the information on main disease classifications in each clinical department in a hospital from January 1st to June 30th, 2002. According to the principles of disease classification in clinical pathway, the disease classification in clinical pathway for trial was decided. Then, according to theories and methods such as Evidence-based Medicine(EBM), Business Process Reengineering(BPR), weighted and moved average method and Vilfredo Pareto chart method, we performed the design of hospitalization time, practice range, contents and items in medicne and treatment flow of clinical pathway, which was put into practice in clinical departments in October, 2002. Systematic analysis and evaluation of the results were conducted after a period of practice(5 months).The results of the study revealed that clinical pathway, an advanced mode for the control of medical quality, was of significant effects on the decreases in average lengh of days and average hospitalization cost, increase in turnover times of beds, improvement of economic returns and social returns of hospital, practice of holistic nursing idea, standardization of diagnosis and treatment behaviors and promotion of the satisfaction of patients. Clinical pathway was coincident with the policies of medical health of "low cost and wide coverage". In addition, the practice of clinical pathway also revealed that the current running system, traditional habits and service idea were not able to meet therequirements of the complete practice of clinical pathway. Therefore, it requires that hospital administrators should conduct innovation, adequate demonstration, systematic training and reasonable arrangement so that the effects of clinical pathway could be brought into full play. Clinical pathway, originated from America, is gradually adopted in many advanced countries in the world. It was introduced into Chinese Mainland in 1998 and attracted the attention of some hospital administrator thereafter. The study of the flow design, evaluation of the efficency, basic theories and organization and practice of clinical pathway in the control of medical quality may be helpful to the wider application in our country.