在实施可持续质量干预后,手术室供应成本和护理价值
Amanda C Filiberto1, Tyler J Loftus1,2, Cristina J Crippen1
1From the Department of Surgery, University of Florida Health, Gainesville, FL (Filiberto, Loftus, Crippen, Balch, Efron, Sarosi, Upchurch).
Journal of the American College of Surgeons
|January 15, 2024
概括
实施质量改善干预措施显著降低了手术室供应成本,并提高了护理的价值. 这种自动化系统为降低成本提供了可操作的见解,而不会影响患者的结果.
科学领域:
- 医疗保健管理的管理
- 手术手术手术手术手术手术手术手术
- 提高质量 提高质量
背景情况:
- 手术室供应成本呈现变化,影响资源利用和护理价值.
- 低于最佳的资源使用和低值的护理与手术室供应成本的可修改因素有关.
- 本研究详细介绍了一项旨在降低这些成本的质量改善 (QI) 计划的实施情况.
研究的目的:
- 通过一种新的质量改善干预措施,降低手术室供应成本.
- 通过优化手术环境中的资源配置来提高护理价值.
- 利用电子健康记录 (EHR) 数据进行绩效反和降低成本.
主要方法:
- 开发了一个自动化的EHR数据管道,以整合供应成本数据与患者特征和结果.
- 观察到预期的比率和护理指标的值被计算为住院手术.
- 创建了外科医生特定的成本数据和控制图表,并与外科医生和部门负责人分享,以指导供应使用.
主要成果:
- 与对照队列相比,干预队列显示每例中位数成本 (811美元与1080美元相比,p < 0.001) 显著降低.
- 在干预后,失控病例 (高成本) 的发生率下降 (6.2% vs 10.3%,p = 0.03).
- 干预组的护理价值有所改善 (1.1对1.0,p=0.04),患者治疗结果 (如住院时间或死亡率) 没有显著差异.
结论:
- 一个自动化和可持续的QI干预有效地降低了手术室供应成本.
- 干预与护理价值的增加有关,这表明相对于成本来说,结果更好.
- 这种方法表明了在外科手术供应链管理中以数据驱动的质量改进的潜力.
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