Introduction of an outcome evaluation system at the time of discharge of the hospital for variance analysis of a critical pathway

Abstract

Although a critical pathway is useful for a standardization of medical care, improvement of quality, and establishment of a management base, variance analysis is indispensable to guarantee proper content. Although the Kagawa Rosai Hospital had introduced a variance analysis system using an electronic critical pathway, the variance registration was such a serious task, and sufficient registration could not be obtained.

Therefore a new system, which performs the registration of the outcome evaluation at the time of discharge of the hospital, was introduced. The outcome was classified into two types：a “common outcome” and a “critical pathway specific outcome”. The “common outcome” was compiled from four items：the “clinical outcome”, the “QOL outcome”, the “time outcome”, and the “economic outcome” which is common in all critical pathways. The “critical pathway specific outcome” was complied from an item reflecting the trait of each critical pathway.The outcome evaluation registration at the time of hospital discharge became possible, and data collection for the critical pathway analysis became easily possible.

Although this system just started operation, the hospital wants to analyze the components of the medical quality (structure, process, and outcome) using various evaluation indexes accumulated from now on, and plans to continuously reform its critical pathway in the future.