In 1992 KPNW adopted an automated data collection system, creating a single repository which tied together data from 24 separate departmental systems. This system is now used by KPNW's entire care delivery staff and is available in every location. The impact, as assessed by multiple instruments, shows a pattern of significant improvement in many aspects of care, with increasingly positive clinician attitudes. Specific examples of improved care include outcomes data and cost control benefits. National recognition has ensued.
to article >> | to pdf >>

The anticoagulant warfarin requires meticulous laboratory monitoring and is frequently associated with drug-induced hospitalization. Originated in 1991, CPAS assists physicians and patients in management of warfarin therapy, and was later enlarged to include low molecular weight heparin therapy for deep venous thrombosis. Most management is by clinical pharmacists. Data regarding thromboembolism and bleeding episodes related to warfarin before and after CPAS show substantial benefits, and use of low molecular weight heparin reduced hospitalizations. There is improved quality of anticoagulation therapy with reduced rates of bleeding, thromboembolism, hospitalization, and death.
to article >> | to pdf >>

Diabetes is responsible for much increased morbidity and mortality, from many complications. In 1995, a multidisciplinary team approach to adult diabetes care was launched which emphasized a primary-care team approach and use of care managers. Since the program's inception, statistically significant improvements have been seen in multiple clinical measurements. This effective program is easily transferable to other facilities.
to article >> | to pdf >>

This 1944 article reports data about 623 hernioplastic procedures performed in a 21-month period at the Oakland, CA, Permanente Foundation Hospital. There was no mortality and almost no surgical complications, but 23% suffered minor or major pulmonary complications, not reduced by sulfadiazine prophylaxis. Of note is the fact there were no pulmonary complications in a small subset of persons ambulated on the first or second postoperative day.
to article >> | to pdf >>

This review describes the fibromyalgia syndrome, which is of unknown etiology and affects 3-6 million people in the US. The article describes the characteristics of fibromyalgia rheumatica, including the specifics of how to establish a diagnosis. A multidisciplinary management approach is described and advised with an algorithm detailing specific nonpharmacological and pharmacological treatment options. A table with addresses and phone numbers of potential support groups and services is included.
to article >> | to pdf >>