けん板断裂修復術のクリティカルパス

概要

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We studied the effect of the critical path introduced into repair of a rotator cuff tear. The subjects comprised of 17 cases using the critical path excluding massive tears and 9 cases before introduction of the critical path. In setting the outcome (criteria for discharge, number of days in hospital) removal of the abduction brace and daily activities such as taking a meal and washing face were used as the criteria for discharge. The clinical outcome, number of days in hospital, the patient's satisfaction, staff member, satisfaction and the financial outcome before and after introduction of the critical path were studied in these cases. As a result, the number of days in hospital shortened. No difference in the chinical outcome was found despite the shortening of the duration in hospital. The path for patients resulted in improvement of informed consent, a decrease in work due to unified instruction and an increase in satisfaction of staff members owing to the team treatment (bringing professional skill of different job categories into full play). At present in Japan, a shift from the process-piling type medicare to the outcome management is being called for. The critical path is said to be one of the most effective tools for the outcome management. It is considered effective for rotator cuff tears as well.
日本肩関節学会の論文