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  1. The successful implementation of pharmaceutical practice guidelines : Analysis of associated outcomes and cost savings.

    Article - En anglais

    Background-Although approximately 2,000 medical practice guidelines have been proposed, few have been successfully implemented and sustained.

    We hypothesized that we could develop and institute practice guidelines to promote more appropriate use of costly anesthetics, to generate and sustain widespread compliance from a large physician group, and to decrease costs without adversely affecting clinical outcomes.


    A prospective before and after comparison study was performed at a tertiary care medical center.

    Clinical outcomes data and times indicative of perioperative patient flow were collected on the first of two sets of patients 1 month before discussion of practice guidelines.

    Practice guidelines were developed by the physicians and their associated care team for the intraoperative use of anesthetic drugs.

    A drug distribution process was developed to aid compliance.

    Clinical outcomes data and times indicative of perioperative patient flow were collected on the second set of patients 1 month after institution of practice guidelines.

    Hospital drug costs and adherence to guidelines were noted throughout the study period and for each of the following 9 months by querying the database of an automated anesthesia record keeper.


    A total of 1,744 patients were studied.

    Drug costs decreased from 56 dollars per case to 32 dollars per case as a result of adherence to practice guidelines.

    Perioperative patient flow was minimally affected. (...)

    Mots-clés Pascal : Anesthésique, Prescription médicale, Choix, Anesthésiste, Personnel sanitaire, Recommandation, Pratique professionnelle, Hôpital, Récupération, Homme, Contrôle coût, Economie santé, Etats Unis, Amérique du Nord, Amérique, Observance

    Mots-clés Pascal anglais : Anesthetic, Medical prescription, Choice, Anesthesiologist, Health staff, Recommendation, Professional practice, Hospital, Recovery, Human, Cost control, Health economy, United States, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0294255

    Code Inist : 002B02B08. Création : 15/07/1997.