通过利用管理战略实施实践指南:潜力与挑战

A. Gray Ellrodt MD (Director of Division of General Internal Medicine), Laura Conner RN (Research Nurse), Mary S. Riedinger RN (Research Associate), Scott Weingarten MD, MPH (Director of Health Services Research)
{"title":"通过利用管理战略实施实践指南:潜力与挑战","authors":"A. Gray Ellrodt MD (Director of Division of General Internal Medicine), Laura Conner RN (Research Nurse), Mary S. Riedinger RN (Research Associate), Scott Weingarten MD, MPH (Director of Health Services Research)","doi":"10.1016/S0097-5990(16)30573-5","DOIUrl":null,"url":null,"abstract":"","PeriodicalId":76392,"journal":{"name":"QRB. Quality review bulletin","volume":"18 12","pages":"Pages 456-460"},"PeriodicalIF":0.0000,"publicationDate":"1992-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0097-5990(16)30573-5","citationCount":"12","resultStr":"{\"title\":\"Implementing Practice Guidelines Through a Utilization Management Strategy: The Potential and the Challenges\",\"authors\":\"A. Gray Ellrodt MD (Director of Division of General Internal Medicine), Laura Conner RN (Research Nurse), Mary S. Riedinger RN (Research Associate), Scott Weingarten MD, MPH (Director of Health Services Research)\",\"doi\":\"10.1016/S0097-5990(16)30573-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"\",\"PeriodicalId\":76392,\"journal\":{\"name\":\"QRB. Quality review bulletin\",\"volume\":\"18 12\",\"pages\":\"Pages 456-460\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1992-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1016/S0097-5990(16)30573-5\",\"citationCount\":\"12\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"QRB. Quality review bulletin\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0097599016305735\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"QRB. Quality review bulletin","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0097599016305735","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 12

摘要

尽管目前对实践指南有很大的热情,但在它们的开发上花费的精力和资源远远多于在它们的实施上。一项前瞻性介入试验采用先前验证的明确实践指南(辅助决策)进行,以减少选定的“低风险”胸痛患者的住院时间。选择利用管理(UM)协调员(rn)和医生来实施指南,因为大多数医院都有这些资源人员,可以推广经验。通过对624例患者使用明确的评价标准,发现当UM协调员应用该指南时,其敏感性为0.85,特异性为0.90,阳性预测值为0.76,阴性预测值为0.94。在51%的时间里,主治医生未能推翻错误分类的低风险患者建议。隐性评价认为,理论上,两名患者的预后可能会恶化。然而,入院后30天的随访显示,根据指南错误分类出院的患者没有不良后遗症。在大多数机构中,利用管理似乎是一种很有前途的指导方针实施机制。但是,应该严格评估统一管理协调员执行指导方针的准确性。指南应在一个相互制衡的环境中实施,在这种环境中,医生对患者的护理负有最终责任。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Implementing Practice Guidelines Through a Utilization Management Strategy: The Potential and the Challenges
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Health Reform Principles for Quality: Recommendations for the Congressional Debate Ensuring Excellence: Reconceptualizing Quality Assurance, Risk Management, and Utilization Review Cascade or Facade: Focusing or Obfuscating the Pathogenesis of latrogenesis? A Quality-of-Care Analysis of Cascade latrogenesis In Frail Elderly Hospital Patients Screening and Managing Abdominal Aortic Aneurysms at the Ochsner Clinic: Suggested Algorithm and Method of Derivation
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1