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J Korean Soc Emerg Med > Volume 22(5); 2011 > Article
Journal of The Korean Society of Emergency Medicine 2011;22(5): 446-465.
Critical Pathway Implementation for Minor Motor Vehicle Trauma Patients
Chong Kun Hong, Young hwan Lee, Ae Jin Sung, Jun Ho Lee, Kwang Won Cho, Seong Youn Hwang, Ji Mi Shin
1Department of Emergency Medicine, Samsung Changwon Hospital Sungkyunkwan University School of Medicine, Changwon, Korea. schsfc@hanmail.net
2Department of Nursing, Samsung Changwon Hospital Sungkyunkwan University School of Medicine, Changwon, Korea.
The high rate of road traffic crashes and rising medical costs are critical health care problems in Korea as well as in the United States. To reduce the medical cost of minor traffic accidents, we hypothesized that implementation of a 7-day critical pathway (CP) for minor car accident patients (MCP) would decrease medical costs and hospitalization time without lowering patient satisfaction level.
A pretest-posttest experimental design was used to verify the effects of CP on MCP, from June 1 to December 31, 2010. A 7-day admission schedule with daily predefined order communication system (OCS) order set was implementated for MCP. On the day of discharge, MCP completed a satisfaction survey, and the total medical cost and cost per day were calculated. Satisfaction with physician and nursing care were also surveyed using the Brief Encounter Psycho-Social Instrument-Korea tool.
Overall rating did not differ in patients processed normally and using the CP, but length of admission was reduced in CP patients. Total medical costs were not different in either group but cost per day was higher in the CP group. Satisfaction with physicians, but not nurses, satisfaction was improved after CP implementation.
A critical pathway for MCP reduces length of admission without decreasing patient satisfaction. Total medical costs are not changed after CP implementation but cost per day is significantly increased. Improved job satisfaction in physician but not for nurses was observed after CP implementation. It seems that CP is a effective tool for MCP.
Key words: Critical pathways, Accidents, Traffic, Patient satisfaction
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