PMID: 9431799Jan 31, 1998Paper

Cost-effective management of high-risk patients: a case-map approach

The Annals of Thoracic Surgery
A S Wechsler

Abstract

The case-management approach to patient care used by most cardiac surgical practices frequently highlights patients designated as high-risk. Increased risk might be because of advanced age, the need for complex reoperations, high risk of bleeding, and renal failure, all of which may be superimposed on poor ventricular performance. A small consensus panel of cardiac surgeons, anesthesiologists, perfusionists, cardiac-care nurse managers, and coagulation experts met to assess the potential for development of case-management pathways targeted towards high-risk coronary artery bypass graft patients. The process comprised review of the literature to identify risk factors and strategies most cost-effective in reducing risk. A series of management strategies driven by data from the literature--or by consensus when such information was not available--were developed to cost-effectively manage the high-risk patient. The process was then converted to a multidimensional computer program. This personal computer-driven program served as a framework upon which any institution could impose its own practice style and modify recommendations. The program was designed to be interactive and to allow easy transition from patient-management strategie...Continue Reading

References

Dec 1, 1992·The Annals of Thoracic Surgery·D M CosgroveF D Loop
Nov 1, 1994·The Annals of Thoracic Surgery·P S PeighK S Naunheim
Oct 1, 1993·The Annals of Thoracic Surgery·J P SchönbergerC R Wildevuur
Nov 1, 1993·The Annals of Thoracic Surgery·T K Rosengart

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Citations

Jan 5, 2000·The Annals of Thoracic Surgery·R AscioneG D Angelini
Jun 1, 2016·Frontiers in Psychology·Auria AlbaceteRosa Ayesa-Arriola
Oct 3, 2006·Current Opinion in Anaesthesiology·A Bach

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