概括
实施护理指南显著减少了急诊室的访问,并为高频使用者提供了不偿付的费用. 这一战略有效地将患者与适当的医疗资源联系起来,提高了系统的效率.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 提高医疗保健的质量 改善医疗保健的质量
- 患者资源管理 患者资源管理
背景情况:
- 高频率使用者 (患者≥10次紧急诊所访问/12个月) 压迫医疗保健资源,并导致过度拥挤.
- 需要有效的干预措施来管理高频利用及其相关成本.
- 护理指南在解决高频用户的需求方面表现有前途.
研究的目的:
- 评估实施高频使用者的护理指南对急诊室访问频率和未偿还的护理费用的影响.
- 评估护理指南是否通过解决患者需求和促进病例管理,可以减少资源的滥用.
主要方法:
- 2014年9月启动了一项质量改进项目,涉及对高频用户实施护理指南.
- 多学科的工作人员 (医生,护士,病例经理,社会工作者) 在实施之前就护理指南协议接受了教育.
主要成果:
- 观察到高频用户数量大幅下降,从2013年的338人减少到2021年的68人.
- 高频使用者的紧急诊所总数从2013年的6025次下降到2021年的1033次.
- 无偿护理费用大幅下降,从2013年的2,068,063美元降至2021年的589,298美元.
结论:
- 实施护理指南被证明是减少高频率使用者急诊室访问的成功策略.
- 护理指南有效降低了与高频利用相关的无偿护理费用.
- 通过护理指南提供教育和资源,使高频用户能够获得适当的医疗保健服务,提高整体系统效率.
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