{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:15:16Z","timestamp":1779106516485,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Standardized outcome measurement is a core component of value\u2010based healthcare, yet real\u2010world evidence on long\u2010term system\u2010wide implementation remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the longitudinal clinical and patient\u2010reported outcome impact of implementing condition\u2010specific, outcome\u2010driven care pathways across multiple specialties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between 2017 and 2024, 9549 patients were enrolled in ten pathways. Patient\u2010Reported Outcomes (PROMs) collection, digital follow\u2010up, and dedicated monitoring teams were progressively introduced. Temporal trends in risk\u2010adjusted clinical outcomes, functional recovery, and quality\u2010of\u2010life measures were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Annual enrollment increased from 642 to 1728 patients, while PROMs completion rose from 38% to 70.1%. Twelve\u2010month loss to follow\u2010up declined from 29% to 17%. Case\u2010mix complexity increased (\u2265\u20092 comorbidities: 41% to 53%). Despite this, 30\u2010day readmissions fell from 11.8% to 7.5%, 1\u2010year mortality from 6.4% to 5.3%, length of stay from 6.2 to 5.4 days, and surgical complications from 14.6% to 10.2%. Stroke functional independence increased (52% to 64%), heart failure symptom burden declined, and elderly CHF readmissions decreased (13.0% to 7.5%). Arthroplasty patients more frequently achieved clinically meaningful improvement (76% to 89%), while postoperative readmissions declined. In spinal surgery, disability scores improved and persistent opioid use decreased (28% to 16%). Oncology pathways showed better quality\u2010of\u2010life, faster treatment initiation, and fewer emergency visits. Post\u2010COVID and sepsis survivors demonstrated improved functional recovery, and neonatal pathways showed enhanced parental confidence and reduced emergency visits. Twelve quality\u2010improvement initiatives were launched; eight pathways demonstrated statistically significant post\u2010implementation outcome gains.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Systematic outcome measurement was associated with sustained improvements in survival, complications, functional recovery, and quality of life, even in increasingly complex populations, supporting its role as a driver of continuous patient\u2010centered care improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70452","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T07:32:34Z","timestamp":1776929554000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transforming Care through Outcomes Measurement: Experience in a Southern Brazilian Hospital"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7577-464X","authenticated-orcid":false,"given":"Jonas Michel","family":"Wolf","sequence":"first","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Pille","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas Felipe","family":"Kist","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Petek","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samanta Brangel","family":"Pereira","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana Allende","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilze Alves","family":"Quessada","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafaela Munari","family":"da Silva","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio Santiago","family":"Soper","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju\u00e7ara Gasparetto","family":"Maccari","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Ant\u00f4nio","family":"Nasi","sequence":"additional","affiliation":[{"name":"Hospital Moinhos de Vento Porto Alegre Rio Grande do Sul Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011024"},{"key":"e_1_2_11_3_1","first-page":"50","article-title":"The Strategy That Will Fix Health Care","volume":"91","author":"Porter M. 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