The Synergy of Pathways and Algorithms: Two Tools Work Better Than One

Schriefer, Janice

doi:10.1016/s1070-3241(16)30095-5

Cited by 28 publications

(13 citation statements)

References 8 publications

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“…As well as those listed in the box, these include a reduction in the length of stay in hospital,4 9 13 21 22 23 24 25 26 27 28 29 30 31 reduction of costs of patient care,22 28 29 32 improved patient outcomes (improved quality of life, reduced complications),9 33 increased patient satisfaction with the service,34 35 improved communication between doctors and nurses,27 33 34 increased participation of patient or carer in patient care,36 and reduction in the time health staff spent carrying out paperwork 22…”

Section: How To Use Integrated Care Pathwaysmentioning

confidence: 99%

Integrated care pathways

Campbell

Hotchkiss

Bradshaw

et al. 1998

BMJ

815

620

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Section: How To Use Integrated Care Pathwaysmentioning

confidence: 99%

Integrated care pathways

Campbell

Hotchkiss

Bradshaw

et al. 1998

BMJ

815

620

View full text Add to dashboard Cite

“…Clinical Pathways. Clinical pathways (also known as critical pathways) or broad care guidelines are being developed by and for clinicians to provide a general path forward to guide care for patients with common health problems (Schriefer, 1994). Pathways are based on the premise that standardization of care processes around best-known methods will tend to produce the best health results.…”

Section: Improvement Models: Common Methods and Case Examplesmentioning

confidence: 99%

Using outcomes measurement to improve quality and value

Nelson

1996

New Directions for Mental Health Services

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The relationship between quality and value is demonstrated through improvement models and case examples. Principles and special issues relevant for improvement models in mental health are discussed.There is much talk about outcomes measurement (Ellwood, 1988; Tarlov and others, 1989) and about quality and value improvement (Batalden and Stoltz, 1993; JCAHO, 1993). Much of the rhetoric, however, and much of the writing treats these two concerns-outcomes measurement and quality and value improvement-as two separate entities. In fact, they are related: they are the opposite sides of the same coin, as I show in this chapter. In demonstrating how integral the relationship is between outcomes measurements and quality and value improvement, I provide both a panoramic view of the field of measurement and improvement and offer a few specific case examples to illustrate key points. Basic Framework: Transitions in Health and ValueThe first thing that is useful in exploring the measurement-improvement dyad is an overarching framework that is dynamic, flexible, and focuses attention on meeting the changing needs of people over time. The framework has the following components:Needs. Patients or clients of health providers enter the health care system with a set of health-related needs, and if care is successful, the patients' needs are met as time passes.Episodes. The patient's journey through the health care system occurs over time and can be thought of as a longitudinal "episode" of treatment. In many chronic illness situations, the points labeled as the beginning and end of the episode are arbitrary NEW DIRECTIONS FOR MENIAL HEALTH SERVICES, no. 71. Fall 1996 0 Jossey-Bass Publishers 111

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“…In the USA, many professional organizations and the Agency for Health Care Policy and Research (AHCPR) are developing research-based clinical practice guidelines. Care organizations have reduced practice pattern variation internally and reduced costs without compromising quality by using guidelines [61,62]. Implementation of AHCPR pain management guidelines has reduced hospital lengths of stay for patients experiencing chest surgery, hysterectomy, total knee replacement and total hip replacement [63].…”

Section: Reducing Practice Pattern Variationmentioning

confidence: 99%

US health‐care revolution: cost and quality challenges

Larrabee

1996

International Journal of Quality Science

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SupplementThe US health-care system is experiencing a revolution, a major paradigm shift[1], as organizations "reinvent" themselves to put more emphasis on primary care and the holistic continuum of care than on illness care[2], as prepaid or capitated health plans rapidly gain market share in all geographical regions, and as health-care organizations [2][3][4][5], like other businesses [6], are deconstructing themselves through downsizing, re-engineering, and creating networks. Simultaneously, organizations that have embraced continuous quality improvement principles and strategies are experiencing incremental changes in their processes of care [7]. Clinicians may perceive these changes to be a veritable chaos, produced by data-free change strategies. Prediction of the future nature of the US health-care system is confounded by the lack of standardized clinical data elements and quality indicators, current telecommunications limitations, and the many complex, competing factors which are propelling change. Among these factors are concern for quality, the changing role of the consumer in health care, but, most especially, the concerted efforts to contain health-care cost escalation [2,8,9]. This article discusses challenges pertaining to these factors that providers, payers and policy makers must grapple with to shape the future US health-care system.First, consumerism and pursuit of market share challenge organizations to "reinvent" consumer-valued services and processes in a cost-effective manner that maintains or improves quality. Many such changes have been implemented without empirical data regarding the consequences of those changes. Research of the influence of various service delivery models on patient satisfaction and quality indicators is needed to help administrators and providers meet this challenge. Similarly, also needed is consumerism and the changing role of the consumer challenge providers to share information that meets their consumers' needs in a manner that they can use in making choices. This dimension of care continues to be a source of patient dissatisfaction. Research on the effectiveness of information sharing in various populations would help providers meet this challenge.Second, concerns for quality challenge organizations and providers to be accountable for improving processes and outcomes of care by decreasing practice pattern variation and associated differences in outcomes. Use of clinical practice guidelines has been initiated to help reduce practice pattern variation

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The Synergy of Pathways and Algorithms: Two Tools Work Better Than One

Cited by 28 publications

References 8 publications

Integrated care pathways

Integrated care pathways

Using outcomes measurement to improve quality and value

US health‐care revolution: cost and quality challenges

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