为患有出血障碍的患者改善结果和节省成本:质量改进项目
Samuel A Merrill1, Sylvia E Webber1, Laura J Merrill2
1Department of Medicine, Section of Hematology/Oncology, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
概括
在血友病治疗中心 (HTC) 实施统一的指导方针显著减少了可预防的住院和急诊室访问,增加了预防的使用,并证明了在出血障碍护理方面大幅节省成本.
科学领域:
- 提高质量 提高科学 提高质量
- 血液学 血液学 血液学
- 医疗保健管理的管理
背景情况:
- 在血友病治疗中心 (HTC) 治疗出血障碍的最佳护理在满足国家标准方面面临挑战.
- 改进的护理方案可能会减少出血事件和相关的医疗费用.
研究的目的:
- 通过有针对性的干预措施,增强患者护理并实现成本节约.
- 关键目标包括减少可预防的住院和急诊室访问 (PHER),增加严重血友病的预防使用,改善患者-HTC沟通.
主要方法:
- 一个潜在的质量改进项目使用了定义,测量,分析,改进和控制 (DMAIC) 方法.
- 干预措施包括标准化的医生检查清单,增强的沟通策略和专用的医生时间,用于农村HTC的紧急患者管理.
- 通过回顾性图表审查和紧急管理的前性跟踪来评估结果.
主要成果:
- 该干预导致PHER减少85.4%,严重血友病患者的预防使用增加,从58.8%降至100%.
- 观察到显著的成本节约,医院PHER因子成本下降了94.5% (每年每名患者11800美元至640美元).
- 尽管情况有所改善,但HTC诊所的诊所出席率为55.2%,大多数患者需要在诊所外进行管理.
结论:
- 一个精心设计的质量改进项目,强调统一的指导方针和门诊护理,有效地改善了患者的治疗结果,并节省了大量的成本.
- 加强门诊管理对于优化出血障碍治疗和实现经济效益至关重要.
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