没有在走廊里躺着等待:在急诊室的质量改善计划
Thomas Schmutz1, Christophe Le Terrier2,3, Vincent Ribordy2
1Emergency Department, Fribourg Hospitals, Fribourg, Switzerland thomas.schmutz@h-fr.ch.
BMJ open quality
|August 28, 2023
概括
紧急服务部门可以通过实施五项规则战略来消除患者拥挤. 这项质量改进项目实现了在护理区域外等待的零患者,改善了患者流动和安全.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 提高质量 提高质量
背景情况:
- 紧急诊所 (ED) 过度拥挤是一个全球性问题,导致患者的发病率和死亡率.
- 等待护理或住院的患者积累阻碍了护理质量.
- 一个质量改进项目旨在消除在ED护理区域外等待的患者.
研究的目的:
- 实施和维持零患者在ED护理区域外的床上等待的目标.
- 改善患者流动并减少与ED过度拥挤相关的负面结果.
主要方法:
- 利用计划-做-研究-行动 (PDSA) 周期进行代测试和实施.
- 引入了五个关键规则:不躺在护理单位外,向前移动,可用检查室,团队聚集,以及组织拥挤计划.
主要成果:
- 自2021年12月以来,在护理区以外的等候区实现了零患者,无论护理水平如何.
- 确保对生命危险和需要躺卧的脆弱患者立即治疗.
- 在2022年,90%的患者在与医生联系之前的等待时间低于2小时.
结论:
- 该PDSA战略有效地消除了患者流动的内部障碍,防止患者在护理区域之外积累.
- 五项措施的方法很容易被其他管理团队复制.
- 没有患者在护理区域外等待,可以作为ED的质量指标,提高护理安全.
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