自动创建1年的随访预约和提醒可以改善动脉再血管化后的长期随访
David P Stonko1, Shira Mohammed2, Diane Skojec2
1Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA.
American journal of surgery
|October 12, 2023
概括
在手术出院期间安排后续预约显著改善了 carotid revascularization 患者的长期随访 (LTFU) 率. 这项质量改进项目增强了患者护理和中风风险管理.
科学领域:
- 血管外科 血管外科
- 提高质量 提高质量
- 健康 结果 研究 研究 结果
背景情况:
- 在动脉复血管化后,长期随访 (LTFU) 对于患者护理,中风预防和技术监测至关重要.
- 目前的LTFU率在优化术后结果和监测新干预方面存在挑战.
研究的目的:
- 为了提高在动脉再血管化手术后的长期随访 (LTFU) 率.
- 评估旨在提高患者遵守后续预约的质量改进计划的有效性.
主要方法:
- 实施了一项质量改进项目,在手术出院时安排术后和一年的后续预约.
- 使用时间趋势分析 (Q1 2019-Q1 2022),多变量回归和中断时间序列 (ITS) 分析来比较干预前和后的LTFU率.
- 数据包括269名连续患者 (151名干预前,118名干预后).
主要成果:
- 在干预后,整体LTFU率从64.9%显著提高到78.8% (P=0.013).
- 干预后进行的手术与1年随访的概率增加了2.2倍 (95% CI: 1.2-4.0),独立于患者因素.
- 间断时间序列分析证实了干预和改善的LTFU率 (P=0.01) 之间存在显著的积极关系.
结论:
- 在手术出院时主动安排后续预约是改善LTFU率的有效策略.
- 自动提醒患者,加上及时安排预约,可以提高长期跟踪协议的遵守.
- 这些发现支持整合质量改进计划,以优化血管外科手术的手术后护理.
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