The benefits of using clinical pathways for managing acute paediatric illness in an emergency department

Journal of quality in clinical practice Pub Date : 2002-01-12 DOI:10.1046/j.1440-1762.2001.00405.x

Gary J Browne FRACP, FACEM, Helen Giles MNM, Mary E Mccaskill DipPaed, Bruce J Fasher MBBS FRACP, Lawrence T Lam MAppPsy, MPH

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引用次数: 79

Abstract The aim of this study was to provide an evaluation of the overall effectiveness of using a number of clinical pathways in treating common acute paediatric conditions in an emergency department. This was a before and after study conducted on the effectiveness of three clinical pathways (gastroenteritis, asthma, and croup) in the emergency department of the Children’s Hospital at Westmead, conducted over two separate yearly periods January to December 1996 and January to December 1999 representing before and after the introduction of clinical pathways in the emergency department. The main outcomes of the effectiveness of the pathways, namely admission to an in-patient bed, length of hospital stay and re-presentation after discharge from the ED were compared. Other outcomes of interest such as parental satisfaction and patient waiting times were also presented. Any deviation from a key clinical pathway process was reported. A total of 2854 children were managed by a clinical pathway compared to 2680 children managed before clinical pathways were introduced. The admission rate was reduced by threefold (9.1% compared to 23.6%) with a twofold reduction in length of hospital stay (32.7 h compared to 17.5 h). In 3.6% of children using a clinical pathway an unscheduled medical visit or re-presentation to the emergency department occurred after discharge, compared to 4.9% before the use of clinical pathways. No adverse events were reported in these children. In 76 cases deviation from a clinical pathway process was reported. High parental satisfaction was reported for clinical pathways throughout the study. Clinical pathways in this emergency department allowed rapid stabilisation of children, reducing admission rate, with a shortened length of hospital stay and few patients re-presenting after discharge and were well accepted by parents.

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在急诊科使用临床路径管理急性儿科疾病的好处

摘要:本研究的目的是提供使用一些临床途径在急诊科治疗常见急性儿科疾病的总体有效性的评估。这是对韦斯特米德儿童医院急诊科三种临床途径(胃肠炎、哮喘和组)的有效性进行的一项前后研究，分别在1996年1月至12月和1999年1月至12月两个独立的年度期间进行，分别代表在急诊科引入临床途径之前和之后。比较了两种途径有效性的主要结果，即住院次数、住院时间和从急诊科出院后的再次表现。其他结果如家长满意度和病人等待时间也被提出。任何偏离关键临床路径过程的报告。与引入临床路径之前的2680名儿童相比，共有2854名儿童接受了临床路径的管理。入院率降低了三倍(9.1%比23.6%)，住院时间缩短了两倍(32.7小时比17.5小时)。在使用临床路径的儿童中，3.6%的儿童在出院后出现了计划外的医疗访问或再次出现在急诊科，而在使用临床路径之前，这一比例为4.9%。这些儿童没有不良事件的报告。在76例偏离临床路径过程的报告。据报道，在整个研究过程中，父母对临床途径的满意度很高。该急诊科的临床路径允许儿童快速稳定，降低了住院率，缩短了住院时间，出院后很少有患者再次就诊，并得到了家长的认可。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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