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事驱动态度,数据驱动决策:在外科咨询之前优化急诊室的工作
Katherine B Snyder1, Jonathan Ball1, Jason Lees1
1Department of Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Journal of surgical education
|June 25, 2023
概括
在外科咨询之前完成患者工作,可以显著减少急诊室 (ED) 决策时间和停留时间 (LOS). 这种优化改善了患者流动和ED的满意度.
科学领域:
- 紧急医疗 紧急医疗
- 手术咨询 手术咨询
- 医疗保健操作 医疗保健操作
背景情况:
- 急诊室 (ED) 的等待时间和停留时间 (LOS) 显著影响患者的结果和满意度.
- 咨询至决策的时间是导致ED长时间停留的一个关键因素.
- 大约40%的ED患者需要进行子专业咨询.
研究的目的:
- 调查咨询前工作组完成对咨询至决策时间的影响.
- 为了确定在咨询前完成工作是否会减少手术患者的ED等待时间和LOS.
- 测试一个完整的工作组可以减少咨询到决策的时间和ED LOS的假设.
主要方法:
- 在两个月内,从ED进行过夜的全科医疗咨询的回顾性审查.
- 数据收集包括等待时间,LOS,以及咨询前完成的处理程度.
- 统计分析涉及总结统计和双变量测试 (t测试) 来比较组.
主要成果:
- 完整的检查 (在咨询之前进行实验室和成像检查) 显著减少了咨询至决策的时间 (2.5小时 vs 4.9小时,p < 0.0001).
- 完整的训练也显著减少了ED停留时间 (7.9小时 vs 11.4小时,p < 0.0001).
- 这些发现独立于测试结果等待时间或顾问要求的额外测试.
结论:
- 在分专科咨询之前在ED完成手术患者工作,显著缩短了决策时间和整体LOS.
- 实施策略,如护理途径,以优化咨询前的工作,可以减少ED等待时间和LOS.
- 这种方法提高了患者流动,并可能提高急诊室内的患者满意度.
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