吞吐量延迟:原因,预测因素和结果 - 瑞士紧急服务部门的观察队列
Isabelle Arnold1, Jeannette-Marie Busch1, Lukas Terhalle1
1Emergency Department, University Hospital Basel, University of Basel, Basel, Switzerland.
Swiss medical weekly
|May 28, 2023
概括
紧急部门的延误影响了超过三分之一的患者,通常是由于住院工作,成像或咨询. 识别预测因素,如年龄和非特定的投诉在分拣可以帮助简化患者的护理和减少等待时间.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 临床操作 临床操作
背景情况:
- 紧急服务部门 (ED) 的吞吐时间对于患者护理至关重要.
- 延迟可能源于各种因素,包括成像,咨询和患者的态度.
- 确定延迟的预测因素对于资源分配和有效的患者流动至关重要.
研究的目的:
- 根据紧急医生的判断,确定紧急部门延误的原因,预测因素和结果.
- 分析导致第三级护理环境中患者吞吐量延迟的因素.
主要方法:
- 两个潜在的ED队列的观察研究 (2017年1月至2月,2019年3月至5月).
- 紧急医生主观地判断了延迟和确定的原因.
- 使用后勤回归分析来评估延迟和相关结果的预测因素.
主要成果:
- 在9818名患者中,37.3%的患者被判定有延迟.
- 患有延迟的患者年龄较大,更有可能有运动障碍,非特定的投诉和虚弱.
- 延误的主要原因包括居民工作 (20.4%),咨询 (20.2%),成像 (19.4%).
- 延迟的预测因素包括分拣敏度 (紧急严重性指数2或3),非特定的投诉,以及咨询/成像的需要.
- 延迟与入院风险增加有关,但死亡率并非如此.
结论:
- 简单的分组预测因素,如年龄,不动,非特定的投诉和脆弱性,可以识别患有延迟风险的患者.
- 住院工作,成像和咨询是ED延迟的主要原因.
- 这项研究为设计未来干预措施提供了基础,以消除紧急部门的吞吐量障碍.
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