title: DRUGS System Improving the Effects of Clinical Pathways: A Systematic Study.
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.
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Shan
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Xiaohe
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Xian
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Zhifu
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Xiaoliang
authors.initials: X
authors.lastname: Qian
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Lixiazi
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.
authors.forename: Huning
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China. wjlbzw@fmmu.edu.cn.
authors.forename: Jingwen
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China. adwen-2004@hotmail.com.
authors.forename: Aidong
authors.initials: A
authors.lastname: Wen
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy; D002387:Cataract Extraction / Q000379:methods; D019091:Critical Pathways / Q000458:organization & administration* / Q000592:standards; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004363:Drug Utilization / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational; D005260:Female; D059685:Herniorrhaphy / Q000379:methods; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008510:Medication Systems, Hospital / Q000458:organization & administration* / Q000592:standards; D008875:Middle Aged; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D058996:Quality Improvement / Q000458:organization & administration; D012985:Software Design; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clinical pathway; Drugs rational usage guideline system; Medical safety; Work efficiency