提升紧急医疗服务 (EMS) 对行为健康紧急情况的响应能力:洛杉矶县的绩效改进计划
Erick H Cheung1,2, Denise A Whitfield3,4,5,6, Adam Kipust7
1David Geffen School of Medicine, Department of Psychiatry, University of California Los Angeles (UCLA), Los Angeles, California.
应急医疗服务 (EMS) 和执法部门 (LE) 对行为健康紧急情况 (BHE) 的反应需要改进. 这一举措旨在通过加强EMS协议和减少LE来优化BHE的响应.
科学领域:
- 紧急医疗服务 紧急医疗服务
- 公共卫生 公共卫生
- 执法部门的反应反应
背景情况:
- 行为健康紧急情况 (BHE) 对紧急医疗服务 (EMS) 临床医生和执法人员 (LE) 构成频繁的挑战.
- 目前管理BHE的最佳实践有限,需要全面审查和改进当前的应对系统.
- 洛杉矶县EMS机构 (LAC-EMSA) 在2016年开始对911-1对BHE的反应进行详细评估,以提高患者和第一反应者的安全.
研究的目的:
- 从最初的呼叫到患者处置,绘制BHE的9-1-1响应过程.
- 在医院前BHE管理中识别和描述响应机构和关键决策点.
- 推干预措施,以提高BHE响应系统的质量和安全.
主要方法:
- 成立了一个多学科委员会 (EMS,LE,卫生机构,公众) 来分析BHE应对系统.
- 医院前BHE反应的过程映射,包括机构角色和决策.
- 数据采集以定量和质量评估可用的服务并确定系统的弱点.
主要成果:
- 对BHE的9-1-1调度标准不一致,经常默认为LE,这可能无意中将危机中的个人定为犯罪.
- 针对BHE的EMS协议,特别是用于管理激动,是有限的,物质使用障碍治疗缺乏整合.
- 对于BHE患者来说,目的地选择和接收设施的能力在运输机构之间有很大差异.
结论:
- 建议将发送协议标准化,并在适当时将主要响应从LE转移到EMS.
- 增加BHE和动荡的EMS治疗方案,以及开发替代运输目的地,可以改善护理.
- 这个倡议强调了需要一个全面的绩效改进战略,以优化911对BHE的反应.
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