在一个大型三级保健城市医院中实施和评估中午前退院倡议
Joint Commission journal on quality and patient safety
|October 16, 2023
概括
中午前出院 (DBN) 计划增加了早些时候出院的患者的百分比. 然而,它没有影响停留时间或再接收时间,并且意外地提高了急诊室登机时间.
科学领域:
- 医疗保健管理的管理
- 医院运营 医院运营
- 优化患者流量优化
背景情况:
- 在中午之前出院患者可能会提高医院的效率,并减少急诊室 (ED) 的入院.
- 评估了午前出院 (DBN) 倡议的有效性,以了解其对医院运营的影响.
研究的目的:
- 评估DBN倡议对患者出院时间的影响.
- 为了确定DBN是否会影响住院时间 (LOS) 和30天再入院率.
- 分析DBN对急救部门 (ED) 登机时间的影响.
主要方法:
- 在12个月的时间段中,采用了回顾性前后研究设计.
- 该DBN倡议包括流程改进,如每日轮整合,电子跟踪和加快服务.
- 统计分析包括卡普兰-梅尔估计,日志等级测试和加速失效时间 (AFT) 建模.
主要成果:
- 在中午之前出院的患者的百分比显著增加,从主动计划后的5.0%增加到11.4% (p < 0.001).
- AFT分析显示,DBN患者的出院时间提前了41.5% (p < 0.001).
- DBN与LOS或30天再入院无独立关联,但ED登机时间中位数增加了41分钟 (p < 0.001).
结论:
- 通过DBN倡议,成功地提高了中午前出院的患者比例.
- 需要进行进一步的研究,以制定提高排放及时性的策略,同时减轻对ED登机时间的不利影响.
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