省略重复的文员工作并不会使心脏病患者处于不利地位,并减少重复
Ravi Chotalia1, Dora Czeke1, Alun Harcombe1
1Nottingham City Hospital NHS Trust, Nottingham, UK.
Future healthcare journal
|October 3, 2023
概括
通过省略冗余的初级医生 (JD) 办事来简化心脏病学入院,可以节省宝贵的时间,并防止一夜之间不必要的患者干扰. 这项质量改进项目发现,经过修订的入院流程,患者护理没有受到任何不利影响.
科学领域:
- 心脏病学 心脏病学
- 改善医疗保健质量 改善医疗保健质量
- 医院管理局 医院管理局
背景情况:
- 诺丁汉大学医院的心脏病科每月管理约320例急诊室 (ED) 住院,主要是在工作时间之外.
- 目前的协议涉及ED医生和心脏病高级护理团队 (CATS) 的初始办事,然后在转移时由值班初级医生 (JD) 进行重新办事.
研究的目的:
- 评估消除初级医生 (JDs) 对心脏病患者的冗余职务的好处.
主要方法:
- 一个质量改进项目比较了CATS团队的书记和计划,与JD计划对100个心脏病学入院进行了比较.
- 审查了九个JD在传统的文职工作上花费的时间,与一种涉及JD审查CATS文职工作,数据和护理讨论的替代方法相比.
- 在两种方法中评估了管理计划的变化和关键干预措施.
主要成果:
- 管理计划仅在5%的案例中被改变,当JD审查现有文职人员时,这表明影响最小.
- 使用新方法,JD职员的平均时间从49.5分钟大幅减少到12.5分钟.
- 护理人员升级了三起病例,其中两起导致开始服用口服抗生素,突出显示了持续的临床警.
结论:
- 忽略初级医生 (JDs) 的重复性办事对心脏病患者来说是安全的,并显著提高了JD的效率.
- 修订后的入院程序节省了值班联合医生的宝贵时间,并避免在一夜之间不必要地唤醒患者,这可能会降低妄想风险.
- 基于这些发现,建议合理化住院系统.
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