开发和评估最佳实践咨询警报,以确定患者是否有资格参加住院治疗计划:一项多中心回顾性研究
Michael J Maniaci1, Ricardo A Torres-Guzman2, Francisco R Avila2
1Division of Hospital Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Journal of hospital medicine
|January 20, 2024
概括
一个新的电子健康记录工具 (最佳实践咨询) 有助于识别患者进行医院在家护理. 然而,只有很小一部分被提醒的患者最终被转移,这凸显了在住院入院方面的挑战.
科学领域:
- 医疗信息学 医疗信息学
- 医疗保健提供模式 医疗保健提供模式
- 患者护理管理的管理.
背景情况:
- 在家医院 (HaH) 护理改善了结果和成本效益,但在患者选择方面面临挑战.
- 对于临床医生来说,手动查HaH资格是耗时的.
- 电子健康记录 (EHR) 工具,如最佳实践建议 (BPA) 可以简化 HaH 候选人识别.
研究的目的:
- 开发和实施BPA以确定符合条件的患者参加梅奥诊所在家高级护理 (ACH) 计划.
- 为了评估供应商对BPA警报的反应.
- 分析触发BPA并影响转诊决定的患者特征.
主要方法:
- 住院患者的回顾性多中心研究引发了ACH资格BPA (2021年3月至12月).
- 数据提取包括患者人口统计,诊断和提供者特征.
- 分析重点是BPA通知结果,转诊率和影响提供商决策的因素.
主要成果:
- 在2847名患者中引发了8962个BPA通知.
- 提供者引用了11.4%的通知 (324个独特的患者).
- 只有9.6%的转诊患者被接受并转移到ACH;护士,护理人员和实习生比主治医生更低的转诊几率.
结论:
- 在EHR系统中,BPA可以识别潜在的家庭医院候选人.
- 在BPA警报和实际的患者转移到HaH之间存在显著的差距.
- 提供者的角色和潜在的特定场所因素影响了转介决策,需要进一步调查.
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