Development of a Flexible Critical Pathway with Electronic Medical Record for Gastrectomy Patients in a University Hospital

Bae, Myung Sun; Song, Jung Hup

Journal of Korean Society Quality Assurance Health Care 2012;18(1): 37.
Published online December 30, 2012.

위 절제술 환자의 진료계획표 개발 및 전자 의무 기록화

배명순¹, 송정흡²

¹경북대학교병원 간호부
²경북대학교병원 공공보건의료사업실

Development of a Flexible Critical Pathway with Electronic Medical Record for Gastrectomy Patients in a University Hospital

Myung Sun Bae¹, Jung Hup Song²

¹Department of Nursing, Kyungpook National University Hospital
²Division of Public Health Medical Service, Kyungpook National University Hospital

Abstract

Objectives
This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients.
Methods
Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients.
Result
The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful.
Conclusion
Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

Key words Critical Pathway;Electronic medical record;