Abstract
On March 1998 in our hospital, subcommittee of critical path was established in the critical committee, in order to improve quality and efficacy of medicine. On June of that year first critical path was introduced to surgical management of cataract. 51 paths had been established by February, 2002, for first four years, about medical examinations, surgical operations, chemotherapy, etc.
But there are not a few problems to be solved in practice. There were some problems turned out around the design of critical path and in the practical use, so we undertook the solution of them.
Critical paths were not unified in form and terms because they were designed by various departments. There were a problem of terms that patient cannot understand, so that the purpose of the informed consent cannot be derived. We established “guidelines to design of critical path”, that enabled the form of critical path to be unified.
Critical paths were designed mainly by nurses, descriptions of therapeutical issues and accounts of medical fee were unsatisfactory. 10 working groups were organized including pharmacist and office clerks for the improvement. And this expanded the contents of our medical services.
But there are next subject that critical paths should be linked to ordering systems. And continuous assessment for critical paths are required through analyses of patients' satisfaction and critical variances.
