在应用质量改善措施的机构经验,用于垂体外科手术:临床和资源的影响
Panayiotis E Pelargos1, Aamr Hasanjee2, Benjamin Lee1
1Departments of1Neurosurgery and.
Neurosurgical focus
|December 1, 2023
概括
开发精益六西格玛临床护理途径 (CCP) 显著减少了内镜内外科手术的逗留时间和成本. 中央交易所改善了患者出院的时间,但没有增加再入院或紧急访问.
科学领域:
- 神经外科 神经外科
- 提高质量 提高质量
- 医疗保健服务研究 医疗服务研究
背景情况:
- 内镜内外科手术是复杂的,涉及多个护理阶段.
- 优化患者护理途径对于改善结果和降低成本至关重要.
研究的目的:
- 开发和评估一条精益六西格玛临床护理途径 (CCP) 用于内透视内透视的跨形手术.
- 评估CCP对术后停留时间,再入院和医院费用的影响.
主要方法:
- 一个精益的六西格玛 (定义,测量,分析,改进,控制) 框架被用来开发CCP.
- 这项研究包括228名成人患者,他们接受了针对各种骨底部病变的选择性内镜内切除术.
- 关键指标包括术后停留时间 (LOS),30天急诊室 (ED) 呈现或再入院,以及医院费用.
主要成果:
- 术后平均LOS显著下降,从4.5日降至1.7天 (p < 0.0001).
- 在术后第二天出院的患者比例从23.4%增加到88.8% (p < 0.0001).
- 平均每名患者的医院费用从38326美元大幅下降至26289美元 (p < 0.0001).
- 在前和后的CCP组之间,30天ED呈现或再接收率没有显著差异.
结论:
- 精益六西格玛CPT的实施显著改善了LOS,并降低了内镜内切除的成本.
- 中央控制系统提高了效率,但没有对患者的安全产生负面影响,也没有增加术后资源利用率.
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