{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282680481651968.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.11191/jhm.10.415"}},{"identifier":{"@type":"NDL_BIB_ID","@value":"10435456"}},{"identifier":{"@type":"URI","@value":"http://id.ndl.go.jp/bib/10435456"}},{"identifier":{"@type":"URI","@value":"https://ndlsearch.ndl.go.jp/books/R000000004-I10435456"}},{"identifier":{"@type":"NAID","@value":"40016830625"}},{"identifier":{"@type":"NAID","@value":"130004619253"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2009340269"}}],"dc:title":[{"@language":"en","@value":"Liaison critical pathway for cerebral stroke in the Central Kochi medical care area"},{"@language":"ja","@value":"二次医療圏全体で運用する脳卒中地域連携クリティカルパス"},{"@language":"ja-Kana","@value":"2ジ イリョウケン ゼンタイ デ ウンヨウ スル ノウソッチュウ チイキ レンケイ クリティカルパス"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"Liaison critical pathways (pathways) can be considered a product of incorporating critical path methods for medical collaboration. The Central Kochi medical care area is a regional core city-type area with a population of 570,000. With the objective of improving and making more efficient use of collaborative care for cerebral stroke we developed a liaison critical pathway for application in an entire secondary medical care area. Professionals from various fields at multiple facilities participated in the development and government and medical associations were involved from the start. In July 2008 pathways were introduced with the participation of 5 acute phase hospitals and 27 sub-acute phase hospitals.<br>We focused on collaborative care for cerebral stroke and developed four types of critical pathways based on collaboration patterns. Critical pathways comprised in-hospital pathways and concurrently executed pathways, and did not delve into the contents of medical care. Specifically, issues related to collaboration were managed using collaboration critical pathways, while the contents of medical care were managed using in-hospital pathways. Each of the four critical pathways consists of an overview and an information sharing form. The information sharing form is divided into four parts: an acute phase, recovery phase, maintenance phase and the primary care physician, and it is similar in format to daily critical pathways of in-hospital pathways. This same form was established in all four critical pathways to enable the use even after future changes in collaboration patterns. The pathways are to be implemented for a one-year period from the onset of the acute phase and scheduled to be revised every two years to reflect revisions to medical service fees. Problems regarding the initial stage of implementation were examined during the development.<br>Unification of evaluation criteria and standardization of care in the community can often be achieved during pathway development and the initial stage of implementation. However so far, community-wide support for cerebral stroke, that uses collaboration pathways as tools, is limited to inter-hospital collaboration. Collaboration with primary care physicians and homecare services is still an issue."},{"@language":"ja","@value":"地域連携クリティカルパスは医療連携にクリティカルパスの考え方を取り入れたものと考えている。脳卒中連携の改善と効率化を目的として、二次医療圏全体で運用する脳卒中地域連携クリティカルパスを作成した。高知中央医療圏は人口57万の地方中核都市タイプの医療圏である。作成には行政・医師会が最初から加わり、2008年7月から運用開始され、 計画管理病院5病院、連携病院27病院が参加している。<br>　脳卒中連携に主眼をおき、連携パターンから4種類のクリティカルパスを作成した。医療内容には踏み込まず、連携の問題と、医療の内容を別々のクリティカルパスで管理する形となった。4種類のクリティカルパスはそれぞれオーバービュークリティカルパス＋情報共有用紙の2つから成り立っている。情報共有用紙は急性期、回復期、維持期、かかりつけ医の4つに分かれ、院内クリティカルパスの日めくりに近い形である。連携のパターンが変動しても使えるよう4つに共通している。運用期間は急性期発症から1年間とした。診療報酬の改定にあわせ2年ごとに改定を予定している。 作成から運用初期に当たっての問題点を検討した。<br>　地域での評価基準の統一やケアの標準化など作成から運用の初期でも得られることは多い。しかし、地域連携クリティカルパスをツールとして地域全体で脳卒中を支えるという観点からは病院間での利用に留まっており、かかりつけ医や在宅サービス部門などとの連携が今後の課題である。"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410290696951093120","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000006904762"},{"@type":"NRID","@value":"9000258493828"}],"foaf:name":[{"@language":"en","@value":"Takahashi Kiyoshi"},{"@language":"ja","@value":"高橋 潔"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Chikamori Hospital,Department of Neurosurgery"},{"@language":"ja","@value":"医療法人近森会近森病院 脳神経外科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410290696951093122","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000010578945"},{"@type":"NRID","@value":"9000258493829"}],"foaf:name":[{"@language":"en","@value":"Hiura Toshie"},{"@language":"ja","@value":"日浦 利恵"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Chikamori Hospital,Regional medical liaison office"},{"@language":"ja","@value":"医療法人近森会近森病院 地域連携室"}]},{"@id":"https://cir.nii.ac.jp/crid/1410290696951093121","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000010578946"},{"@type":"NRID","@value":"9000258493830"}],"foaf:name":[{"@language":"en","@value":"Kagimoto Yuki"},{"@language":"ja","@value":"鍵本 由紀"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Chikamori Hospital,Committee of critical pathway"},{"@language":"ja","@value":"医療法人近森会近森病院 クリティカルパス委員会事務局"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"18812503"},{"@type":"LISSN","@value":"18812503"},{"@type":"EISSN","@value":"18846807"},{"@type":"NDL_BIB_ID","@value":"000008198125"},{"@type":"ISSN","@value":"18812503"},{"@type":"NCID","@value":"AA12166447"}],"prism:publicationName":[{"@language":"en","@value":"The Journal of Japan Society for Health Care Management"},{"@language":"ja","@value":"日本医療マネジメント学会雑誌"},{"@language":"en","@value":"JJHM"},{"@language":"ja","@value":"日本医療マネジメント学会雑誌"}],"dc:publisher":[{"@language":"en","@value":"Japan Society for Health Care Management"},{"@language":"ja","@value":"特定非営利活動法人 日本医療マネジメント学会"}],"prism:publicationDate":"2009","prism:volume":"10","prism:number":"2","prism:startingPage":"415","prism:endingPage":"419"},"url":[{"@id":"http://id.ndl.go.jp/bib/10435456"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I10435456"},{"@id":"https://search.jamas.or.jp/link/ui/2009340269"}],"availableAt":"2009","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E5%9C%B0%E5%9F%9F%E9%80%A3%E6%90%BA%E3%82%AF%E3%83%AA%E3%83%86%E3%82%A3%E3%82%AB%E3%83%AB%E3%83%91%E3%82%B9","dc:title":"地域連携クリティカルパス"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%9C%B0%E5%9F%9F%E6%A8%99%E6%BA%96%E5%8C%96","dc:title":"地域標準化"},{"@id":"https://cir.nii.ac.jp/all?q=%E8%84%B3%E5%8D%92%E4%B8%AD","dc:title":"脳卒中"},{"@id":"https://cir.nii.ac.jp/all?q=liaison%20critical%20pathway","dc:title":"liaison critical pathway"},{"@id":"https://cir.nii.ac.jp/all?q=regional%20standardization","dc:title":"regional standardization"},{"@id":"https://cir.nii.ac.jp/all?q=cerebral%20stroke","dc:title":"cerebral stroke"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:1002263072"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I10435456"},{"@type":"CIA","@value":"40016830625"},{"@type":"CIA","@value":"130004619253"}]}