基于三级综合医院病种特点的临床路径管理
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发布人:yaot 发布时间:2022/5/10 16:52:24  浏览次数:884次
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——蔡慧 胡龙军 丁明明 张戟 钱明平

【摘要】针对病种的复杂性和诊治手段的多样性,借鉴流程再造理论和权变理论,创新临床路径管理思路,包括细化分支路径、增设路径备选项、动态调整考核标准,建立了符合三级综合医院功能定位及病种特点的临床路径管理模式。自2018年第二季度以来,全院临床路径完成占比持续保持在50%以上。该模式推动了临床路径深入开展,可扩大三级综合医院临床路径管理覆盖面,为复杂病种临床路径管理提供了参考。
【关键词】临床路径;分支路径;三级综合医院;病种特点
中图分类号:R197.3文献标识码:B
Clinical Pathway Management Based on the Diseases Characteristics in Tertiary General Hospitals/CAI Hui,HU Longjun,DING Mingming,et al.//Chinese Health Quality Management,2022,29(3):30-32
Abstract Based on the complexity of diseases and diversity of treatment methods, a hospital took process reengineering theory and contingency theory for reference to innovate clinical pathway management ideas, including refining branch path, adding path alternatives, and dynamically adjusting the inspection standards. A clinical pathway management mode was established in line with the functional orientation and disease characteristics of tertiary general hospitals. Since the second quarter of 2018, the proportion of clinical pathway completion in the whole hospital had maintained at more than 50%. This mode promoted the in-depth development of clinical pathway, expanded the coverage of clinical pathway management in tertiary general hospitals, and provide reference for clinical pathway management of complex diseases.
Key words Clinical Pathway; Branch Pathway; Tertiary General Hospital; Disease Characteristics
Firstauthor's address Shanghai Tenth People's Hospital, Shanghai,200072, China


临床路径具有提高临床效率、持续改进医疗质量和控制医疗成本等作用。2020年国家卫生健康委员会等八部委发布《关于印发进一步规范医疗行为促进合理医疗检查的指导意见的通知》,强调在2022年底前,三级医院50%出院患者要按照临床路径进行管理。因此,如何采取有效措施推进临床路径管理是目前工作的重点。
上海申康医院发展中心(以下简称“申康”)自2013年起,先后选择一批具有代表性的病种,对市级三级医院开展病种绩效考核[1]。上海市第十人民医院作为申康直属医疗机构,将这些病种纳入临床路径管理,在实践中构建了适应三级综合医院病种特点的临床路径管理模式。