RESUMO
The start-up costs incurred when instituting Hospital Based Managed Care (HBMC) and using CareMaps in a large mid-western teaching hospital are analyzed. The complete cost analysis of developing the first CareMap, Cesarean Section, is included. Cost analysis of an additional CareMap, Normal Vaginal Delivery, is available for comparison for the developmental phase of the CareMap. The CareMaps were designed by the same multidisciplinary team though 18 months apart.
Assuntos
Procedimentos Clínicos/organização & administração , Hospitais de Ensino/organização & administração , Programas de Assistência Gerenciada/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Análise Custo-Benefício , Parto Obstétrico/enfermagem , Feminino , Humanos , Gravidez , Desenvolvimento de Programas , Estudos RetrospectivosRESUMO
A previously undescribed complication involving PAC thermistor temperature readings is characterized in this study. The thermistor readings became falsely elevated after the PAC was immersed in water, increasing steadily to 17.6 degrees C above control temperature readings. The abnormality resolved when the PAC was removed from immersion. A survey of ICUs revealed that PAC thermistors are frequently used to monitor the body temperature of patients requiring PACs. Only seven (35 percent) of 20 surveyed ICUs using PAC thermistors routinely confirmed PAC estimates of body temperature with another thermometric device. Since erroneous temperature measurements can have profoundly deleterious effects on clinical management, routine validation of PAC thermistors should be considered.