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頁籤選單縮合
題名 | Application of PERT/CPM to the Care of Pulmonary Lobectomy Patients=應用PERT/CPM於肺葉切除患者的照顧 |
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作者 | 李麗傳; 李世俊; 王桂芸; 許正義; | 書刊名 | 醫學研究 |
卷期 | 19:5 1999.03[民88.03] |
頁次 | 頁273-283 |
分類號 | 419.73 |
關鍵詞 | 肺葉切除患者; 住院天數; 再住院率; Pulmonary lobectomy patient; PERT/CPM; Length of stay; Early readmission; |
語文 | 英文(English) |
中文摘要 | 由於醫療經費的裁減,造成了臨床醫療的許多改變。應用要徑法(Critical Path Method, CPM)與計畫評核術(Program Evaluation Review Technique, PERT)為心臟手術患者設計的照顧之臨床路徑,證明可以縮短患者的住院天數、減少醫療用以及提昇照顧的品質。本研究的目地是將PERT/CPM應用於臨床肺葉切除患者的照顧,求證是否能獲得相同的結果。 自西元1997年9月起我們成立了臨床路徑醫療小組,成員每月開會一次,設計肺葉切除患者照顧的臨床路徑。自收集的24位肺葉切除出院患者的病歷中取得基本資料,再做PERT/CPM之方法將基本資料分析整理後,制定照顧的流程圖與步驟的時刻表。於西元1997年12月起,採用這已完成的肺葉切除患者照顧的臨床路徑,共有6位肺葉切除患者參與了前驅研究。 結果顯示,將PERT/CPM應用於臨床肺葉切除患者照顧的臨床路徑,因其主張患者早期出院,故自實施後迫使醫生改善了其醫療行為,導致減少了患者的住院天數與再住院率。 |
英文摘要 | Critical paths have been established primarily as a result of imposed economic constraints. The Critical Path Method (CPM) and Program Evaluation Review Technique (PERT) have been used as a framework to establish an effective clinical pathway for open-heart surgery patients and have been shown to improve patient's length of stay, cost, and quality of care. This study investigated whether PERT/CPM can be used to realize similar outcomes with pulmonary lobectomy patients. A multidisciplinary team met on a monthly basis starting in September 1997 to develop a lobectomy clinical path. Twenty-four charts of discharged patients were reviewed retrospectively for basic data collection. The PERT/CPM was used to analyze variances from the clinical pathway. A network flow diagram was used to determine whether sequential relationships existed between activities and clinical outcomes in the care process. Based on these findings, a critical pathway was developed detailing daily goals for the patients and care teams. The pathway was initiated on December 1, 1997. A post PERT/CPM study of 6 cases was performed. The results showed that the pulmonary lobectomy pathway resulted in earlier discharge and a reduction in readmission rates. Important reasons for the success of this method appear to be a multidisciplinary approach, identification and control of high cost areas throughout the hospitalization period, specific care within a standardized frame, and identification of reasons for prolonged stay. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。