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Successful implementation of an evidence-based clinical practice guideline: acute dysuria/urgency in adult women. 成功实施循证临床实践指南:成年女性急性排尿困难/急症。
HMO practice
Pub Date : 1997-12-01
M E Stuart, J Macuiba, F Heidrich, R G Farrell, M Braddick, S Etchison

This paper describes the development and successful implementation of an evidence-based clinical practice guideline dealing with uncomplicated urinary tract infection in adult women (acute dysuria guideline). This guideline was based on an evaluation and synthesis of the medical literature using the best available evidence. Following guideline implementation, clinical practice changes recommended by the guideline were observed, including a significant decrease in laboratory testing and clinic visits for acute dysuria. Successful implementation of this guideline is attributed to the use of an explicit, evidence-based guideline development process, a combination of implementation strategies including decision support for providers, and a change in the roles of registered nurses.

本文介绍了成人女性无并发症尿路感染的循证临床实践指南(急性排尿困难指南)的发展和成功实施。本指南是基于利用现有最佳证据对医学文献的评价和综合。指南实施后，观察到指南所建议的临床实践变化，包括急性排尿困难的实验室检查和门诊就诊显著减少。该指南的成功实施归功于使用了明确的、基于证据的指南制定过程、实施战略的组合，包括对提供者的决策支持，以及注册护士角色的变化。
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引用次数: 0
Preventing adolescent pregnancy. 预防青少年怀孕。
HMO practice
Pub Date : 1997-12-01
J Fine
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引用次数: 0
High hopes: better care for young families. 寄予厚望:为年轻家庭提供更好的照顾。
HMO practice
Pub Date : 1997-12-01
N Smith
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引用次数: 0
Diabetes care: an opportunity for collaboration. 糖尿病护理:合作的机会。
HMO practice
Pub Date : 1997-12-01
S B Yox
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引用次数: 0
Cost-effective management of group A streptococcal pharyngitis. A组链球菌性咽炎的成本效益管理。
HMO practice
Pub Date : 1997-12-01
M E Ryan, S Ervin, P P Bourbeau, W J Malone
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引用次数: 0
Sexual health of teens. 青少年性健康。
HMO practice
Pub Date : 1997-12-01
M P Madwed
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引用次数: 0
Managed occupational health care in an HMO. 在HMO管理职业卫生保健。
HMO practice
Pub Date : 1997-12-01
A Feldstein, G Marino

This paper describes the efforts of an HMO to improve its delivery of occupational health services. Customer needs identification, occupational health structure, data systems, case management, clinical guidelines, and quality management are outlined. Our experience suggests that high-quality occupational health services can be integrated into managed care systems thereby offering cost-effective care to large numbers of workers. Comparing 1991 to 1995, physician authorization of total disability days was reduced 17.9% per disability case (p < .0001). Based on July 1994 to June 1995 Oregon State Accident Insurance Fund (SAIF Corporation) data, HMO average total claim cost was $916/claim representing respectively, a 21% and a 20% reduced cost compared to two PPO model programs (MCO 00 and MCO 01). Patient satisfaction data indicated that 90% of patients were satisfied or very satisfied with the physician they saw. The savings appear to be due to cost-effective treatment and rapid return to work.

本文描述了一个卫生组织的努力，以改善其提供职业卫生服务。概述了客户需求识别、职业健康结构、数据系统、病例管理、临床指南和质量管理。我们的经验表明，高质量的职业卫生服务可以整合到管理医疗系统中，从而为大量工人提供具有成本效益的医疗服务。与1991年和1995年相比，每个残疾病例的医生授权总残疾日减少了17.9% (p < 0.0001)。根据1994年7月至1995年6月俄勒冈州意外保险基金(SAIF Corporation)的数据，HMO的平均总索赔成本为916美元/次，与两个PPO模式项目(MCO 00和MCO 01)相比，分别降低了21%和20%的成本。患者满意度数据显示，90%的患者对他们看到的医生感到满意或非常满意。节省的费用似乎是由于具有成本效益的治疗和迅速恢复工作。
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引用次数: 0
ADA's (American Diabetes Association) provider recognition program. ADA(美国糖尿病协会)提供者认可计划。
HMO practice
Pub Date : 1997-12-01
L Joyner, S McNeeley, R Kahn
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引用次数: 0
Physician development initiative: small group CME. 医师发展倡议:小组CME。
HMO practice
Pub Date : 1997-12-01
D S Holland, J Defontes, M Klau, J Bruss, R Lehmer, M Sultan, M R Brody
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引用次数: 0
Flexible sigmoidoscopy screening: patient acceptance. 软性乙状结肠镜筛查:患者接受度。
HMO practice
Pub Date : 1997-09-01
Y M Trnka, C A Henderson

Although compelling evidence is available that screening can reduce the risk of death from colon cancer, patient compliance with screening in the United States is poor. The objective of this study is to describe a program that uses patient education to improve patient acceptance of flexible sigmoidoscopy screening. Our program provides multiple opportunities for patients to ask questions and to receive information. Preliminary data show that this approach has resulted in a procedure acceptance rate of 81% of those referred in the first year of the program. Future research needs to focus on evaluating factors associated with noncompliance in colorectal cancer screening programs.

虽然有令人信服的证据表明，筛查可以降低结肠癌死亡的风险，但在美国，患者对筛查的依从性很差。本研究的目的是描述一个程序，使用患者教育，以提高患者接受柔性乙状结肠镜筛查。我们的项目为患者提供了多种提问和获取信息的机会。初步数据显示，这种方法在项目第一年的手术接受率为81%。未来的研究需要集中在评估结直肠癌筛查项目中与不依从性相关的因素。
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引用次数: 0
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