医院工作负载的突出措施
Marisha Burden1, Lauren McBeth1, Angela Keniston1
1Division of Hospital Medicine, University of Colorado School of Medicine, Aurora.
JAMA network open
|August 10, 2023
概括
专家们确定了医院工作负载的多种指标,强调了患者的复杂性和结果,而不是传统的生产力指标. 这种全面的方法更好地反映了医院工作需求的细微差别及其影响.
科学领域:
- 医疗保健管理的管理
- 医疗专业主义 医学专业主义
- 医疗保健服务研究 医疗服务研究
背景情况:
- 理想的医院工作量及其最佳测量仍然不太清楚.
- 现有的指标可能无法完全捕捉医院职责及其影响的复杂性.
研究的目的:
- 在评估医院工作负载的关键措施上达成专家共识.
- 确定一套全面的指标,准确地反映医院工作需求.
主要方法:
- 采用了三轮的德尔菲技术,涉及医院医学,领导,管理,人为因素和认知负载的国家专家.
- 调查被用来收集有关各种工作负载指标相关性的定性输入和定量评级.
- 使用四分区间 (IQR) 和百分比协议来评估共识.
主要成果:
- 十七位专家参与了这项研究,在第一轮工作中产生了192个独特的工作量测量结果.
- 在随后的轮次中,与患者复杂性,患者结果 (例如,减少住院日) 和临床医生的流动性相关的措施被确定为高度相关.
- 很大一部分措施被认为是适度相关的,这表明需要采用多方面的方法.
结论:
- 多种措施,包括工作需求及其与结果的关联,对于理解医院工作负载至关重要.
- 仅依靠传统的生产力和财务指标,就会给医院工作提供一个不完整的画面.
- 采取更广泛的措施可以提高对医院工作复杂性及其对临床医生,患者和组织的影响的理解.
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