Outcomes-based practice

Clinical Pathways And Disease Registries

A Disease Registry is a database for people diagnosed with a  particular disease, such as diabetes or hypertension. Hospital Disease  Registries are specific to that hospital. Population disease registries  are specific to a focused geographical sector such as a city, state,  country, etc.

A Clinical Pathway illuminates a potential standard of  practice for the care associated with a particular disease. The pathway  is a guideline that is used to optimize outcomes. Clinical Pathways are  multidisciplinary management tools for evidence-based healthcare  delivery protocol optimization targeting a specific disease and expected  clinical course. Protocols are also useful tools for facilitating the  coordination of care.

Outcomes-based practice (sometimes called outcomes  management) involves a combination of teamwork, continuous quality  improvement, and process and outcome measurement. Outcomes based data  provide the framework for establishing a Clinical Pathway.

search the Internet for information on clinical pathways and disease registries as can be found at the following Web sites:

https://www.ahrq.gov/

http://ccn.aacnjournals.org/content/22/1/31.full

https://www.health.ny.gov/diseases/chronic/diseaser.htm

Cancer is more likely to occur in men than women. Within the United  States the three most common cancers among men are cancer of the  prostate, lung, and colon/rectum. It has been observed that  approximately 1 in 6 men over their lifetime will be diagnosed with  prostate cancer and African American men are two times more likely to  die of prostate cancer than their Caucasian or Asian counterparts.

Prostate cancer screening may involve testing the  prostate-specific antigen (PSA) blood level and performing a digital  rectal exam (DRE) yearly, beginning at age 50, to men who are at average  risk of prostate cancer and have at least a 10-year life expectancy.

Screening may take place starting at age 45 for men at high  risk of developing prostate cancer. This includes African American men  and men who have a first-degree relative (father, brother, or son)  diagnosed with prostate cancer at an early age (younger than age 65).  Very early stage screening should take place at age 40 for men at even  higher risk (those with several first-degree relatives who had prostate  cancer at an early age.)

For this Discussion,

• Identify 2–3 different types of Disease Registries, such  as that for prostate cancer, and the benefits and limitations of the  Disease Registries chosen.
• What are some of the protocols involved in establishing a Clinical Pathway project for the identified diseases?
• What value is there—clinically and economically—in having  health care providers follow Clinical Pathways that have been validated  by Outcomes Reports?
• What is the potential liability associated with a provider not following an established Clinical Pathway?

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