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HILLSIDE HOSPITAL PATIENT PROGRESS RECORD - EXPLORATIONS IN CLINICAL MANAGEMENT BY OBJECTIVE AND EXCEPTION

NCJ Number
50230
Journal
EVALUATION Issue: 1 Dated: SPECIAL MONOGRAPH (1973) Pages: 19-22
Author(s)
G HONIGFELD; D F KLEIN
Date Published
1973
Length
4 pages
Annotation
A CLINICAL GOAL MONITORING SYSTEM, DESIGNED TO CHART PATIENT PROGRESS OVER THE COURSE OF TREATMENT, IS DESCRIBED AND EVALUATED.
Abstract
THE PILOT SYSTEM IMPLEMENTED AT THE HILLSIDE MEDICAL CENTER (NEW YORK) SETS INDIVIDUAL GOALS IN TARGET AREAS AND EXPRESSES THEM AS VALUES ON A SEVEN-POINT SCALE. GOALS REPRESENTING THE DEGREE OF IMPROVEMENT THAT WOULD BE SATISFACTORY ARE BASED ON CLINICAL EXPERIENCE AND INDIVIDUAL PATIENT EXPECTATIONS. ONCE SUCH GOALS ARE ESTABLISHED, A COMPUTER AUTOMATICALLY CHECKS RATINGS IN VIEW OF THESE GOALS AND FEEDS BACK TO CLINICAL STAFF APPROPRIATE MESSAGES PERTAINING TO GOAL ATTAINMENT. PRINCIPAL PRODUCTS OF THE SYSTEM ARE GRAPHIC DISPLAYS ('FEVER CHARTS') IN WHICH PATIENT CHANGE IS PLOTTED ON THE VERTICAL AXIS AND TIME ON THE BASELINE. MONITORING IS CARRIED OUT BY STAFF MEMBERS WHO PERIODICALLY EXAMINE THE 'FEVER CHARTS' PRODUCED BY THE SYSTEM. THE INITIAL PROCESS OF CLINICAL REVIEW IS FACILITATED BY COMPUTER OPERATIONS THAT CONSIDER EACH PATIENT'S STATUS IN LIGHT OF THE QUANTITATIVELY EXPRESSED GOALS PREVIOUSLY DETERMINED BY CLINICAL STAFF. WHEN A PATIENT'S EVALUATIONS MEET OR BETTER PREVIOUSLY DETERMINED GOALS, HIS OR HER 'FEVER CHART' IS MARKED TO CALL ATTENTION TO THE FACT THAT GOAL ATTAINMENT HAS OCCURRED. A SAMPLE PATIENT PROGRESS RECORD IS PROVIDED, AND POTENTIAL USES OF THE SYSTEM ARE EXPLORED. DUE TO SIGNIFICANT PROBLEMS ENCOUNTERED IN THE SYSTEM'S DEVELOPMENT AND USE, PLANS ARE UNDERWAY TO IMPROVE IT AND TO MEET THE NEED FOR VERTICAL REPORTING. (DP)

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