Induction of Critical Pathways in Prostate Cancer : the Importance of the Detailed Outcome

Bibliographic Information

Other Title
  • 前立腺癌の診断と治療におけるクリティカルパスの導入 : 詳細なアウトカム設定の重要性について

Search this article

Description

Prostate cancer is a commonly diagnosed malignancy in men. Systematic prostate biopsy is the most commonly employed technique used in detecting prostate cancer. The most appropriate treatment is primarily determined by the stage and aggressiveness of the disease when it is discovered. Radical prostatectomy is an effective treatment for clinically localized carcinoma of the prostate. Critical pathways were implemented to standardize the diagnosis (prostate biopsy) and therapy (prostatectomy) of prostate cancer. The subjects were 79 patients undergoing prostate biopsy and 7 patients undergoing radical prostatectomy. Three types of critical pathways have been used : the overview pathway, patient pathway and all-in-one pathway. In the early stage, we used two kinds of pathways, the overview pathway and patient pathway. Later the all-in-one pathway extending to detailed outcome criteria was implemented. In the early stage, the critical pathway was implemented as an efficiently organized time schedule for the examinations and treatment, but the guidelines for judging the time point at which variance occurred had not been established. Later a variance report card with the expected outcome described in detail was prepared at the time of discharge after biopsy. However, only 88% of the physicians and 47% of the nurses completed the variance report card. Then we introduced the all-in-one pathway using a format describing the expected outcome in detail on a day-by-day basis. In this format, the outcome was recorded with the variance each day, and it was easy to collect the variance data. We recognized the importance of including the outcome in detail when developing the critical pathway, and the requirement of standard criteria for judgment of variances when they occur.

Journal

Keywords

Details 詳細情報について

Report a problem

Back to top