Abstract
The aim of the study is to assess the feasibility of Drugs Rational Usage Guideline System (DRUGS)-supported clinical pathway (CP) for breast carcinoma, cataract, inguinal hernia and 2-diabetes mellitus whether the application of such a system could improve work efficiency, medical safety, and decrease hospital cost. Four kinds of diseases which included 1773 cases (where 901 cases using paper-based clinical pathways and 872 cases using DRUGS-supported clinical pathways) were selected and their demographic and clinical data were collected. The evaluation criteria were length of stay, preoperative length of stay, hospital cost, antibiotics prescribed during hospitalization, unscheduled surgery, complications and prognosis. The median total LOS was 1 to 3 days shorter in the DRUGS-supported CP group as compared to the Paper-based CP group for all types (p < 0.05). Totel hospital cost decreased significantly in the DRUGS-supported CP group than that in Paper-based CP group. About antibiotics prescribed during hospitalization, there were no statistically differences in the time of initial dose of antibiotic and the duration of administration except the choice of antibiotic categories. The proportion of DRUGS-supported clinical pathway conditions where a broad-spectrum antibiotic was prescribed decreased from 63.6 to 34.5 % (p < 0.01) in the Paper-based group. While after the intervention, the differences were statistically not significant in unscheduled surgery, complications and prognosis. In this study, DRUGS-supported clinical pathway for breast carcinoma, cataract, inguinal hernia, 2-diabetes mellitus was smoothly shifted from a paper-based to an electronic system, and confer benefits at the hospital level.
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This study was conducted under contract by the Army Science and Technology Major Project in the 11th Five-year Plan (06D007) and Natural Science Foundation of China (No. 81302627, 81302903). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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This article is part of the Topical Collection on Systems-Level Quality Improvement
Shan Wang and Xiaohe Zhu contributed equally to this work.
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Wang, S., Zhu, X., Zhao, X. et al. DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study. J Med Syst 40, 59 (2016). https://doi.org/10.1007/s10916-015-0400-6
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DOI: https://doi.org/10.1007/s10916-015-0400-6