Clinical care map for the ambulatory laparoscopic cholecystectomy patient

Pain management following discharge after ambulatory same-day surgery

“…1997, Marley & Swanson 2001). Technological advances in anaesthesia as well as early recovery, rapid turnaround times in surgical services, and fiscal restraints have shifted the focus of postoperative care to the home setting for greater number of patients (Kleinbeck & Hoffart 1994, Bumgarner & Evans 1999, Watkins & White 2001). People undergoing complex and potentially more painful surgical procedures may be discharged within a few hours to recover at home.…”

Clinical Caremap Development: How Can Caremaps Standardise Care When They Are Not Standardised?

“…Evolution of caremaps in form and function was expected as information technology and evidencebased medicine developed (Wilson, 1995). Starting from 1999 there began to be examples of transitional caremaps; caremaps that whilst still being text-based, have reduced their focus to interventions limited to the primary diagnosis (Bumgarner & Evans, 1999), (Cholock, 2001), (Philie, 2001).…”

“…As described in Table 1, caremaps have evolved from wordy texts (Goode & Blegen, 1993), (Gordon, 1996), (Holocek & Sellards, 1997), (Matula & Shollenberger, 1999), (Bumgarner & Evans, 1999), (Philie, 2001) to illustrative graphs (Chu & Cesnik, 1998), (Panzarasa, et al, 2002), (Houltram & Scanlan, 2004), (Royall, et al, 2014), (Li, et al, 2014), (Michelson, et al, 2018). Most contemporary caremaps present either as monochromatic, i.e.…”

“…The literature suggests they originated in the nursing domain, incorporating and extending the critical pathway method and bringing established project management methodologies into healthcare delivery (Chu & Cesnik, 1998), (Gemmel, et al, 2008), (Zander, 1992). Caremaps are intended to standardise health services by organising and sequencing care delivery, ensuring a standard of care and timely outcomes using an appropriate level of resources (Blegen, et al, 1995), (Bumgarner & Evans, 1999), (Hampton, 1993), (Marr & Reid, 1992). The caremap can also help track variance in clinical practice, as it provides a simple and effective visual method for identifying when treatment or patient outcomes have deviated from the routine evidence-based pathway (Marr & Reid, 1992), (Houltram & Scanlan, 2004).…”

“…Even within these examples there exists significant variance in complexity level, design approach, content and the representational structures used. There is currently no standardised method for the development or presentation of a clinical caremap (Bumgarner & Evans, 1999). Changes in format between like documents and poorly designed materials increase ambiguity and create confusion for the clinician (Hubner, et al, 2010), (Valenstein, 2008), (Wang, et al, 2013).…”