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优化急性中风治疗过程:从潜在观察时间和运动研究中的子任务持续时间的见解
Gizem Koca1, Mukesh Kumar1, Gord Gubitz2,3
1Department of Industrial Engineering, Faculty of Engineering, Dalhousie University, Halifax, NS, Canada.
Frontiers in neurology
|November 15, 2023
概括
急性缺血性中风治疗的延迟发生在特定的子任务期间,特别是当由非中风神经病学家或日常工作时间之外进行时. 优化这些关键步骤可以显著改善患者的治疗结果和治疗效率.
科学领域:
- 神经学 神经学
- 医疗保健管理的管理
- 医疗过程优化 医疗过程优化
背景情况:
- 对于急性缺血性中风 (AIS) 患者来说,迅速治疗至关重要.
- 优化急性中风协议 (ASP) 涉及将关键性能指标如门到针时间 (DNT) 降至最低.
- 在ASP中识别特定的延误可以揭示过程改进的机会.
研究的目的:
- 识别和分析导致ASP内AIS处理延迟的子任务.
- 为了比较治疗过程的持续时间,在常规时间和下班时间.
- 为了比较中风和非中风神经病学家之间的治疗过程持续时间.
主要方法:
- 进行了两阶段前性观察时间和运动研究.
- 确定和分类了34个子任务.
- 分析了185名AIS患者的治疗过程持续时间和关键性能指标 (DNT,CTNT,CTGP,DGPT).
主要成果:
- 在分拣,注册,病史共享,治疗决策和准备阶段观察到显著的延迟.
- 当非中风神经科医生管理病例或在下班后进行手术时,延迟更为明显.
- 关键的绩效指标 (DNT,CTNT,CTGP) 在非中风神经科医生和下班治疗中显著延长.
结论:
- 在ASP中,特定的子任务是延迟的主要原因.
- 针对性干预,重点是非中风神经科医生和下班照顾,可以优化AIS治疗.
- 提高这些领域的效率有可能显著提高患者的治疗结果.
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