针对急诊医疗人员的个性化吞吐量指标报告:对处置时间和居民看法的影响
Brent A Becker1, Andrew J Bleinberger1, Brandon J Golden1
1Department of Emergency Medicine WellSpan York Hospital York Pennsylvania USA.
AEM education and training
|June 24, 2024
概括
个性化吞吐量指标并没有显著改善居民的急救部门处置时间. 然而,研究生三年级居民的入院患者咨询时间显著减少.
科学领域:
- 紧急医疗 紧急医疗
- 改善医疗保健质量 改善医疗保健质量
- 医学教育 医学教育
背景情况:
- 量化指标报告可以提高急诊医生的表现.
- 很少有研究评估了这些指标对应届医生的影响.
- 这项研究重点关注紧急医疗 (EM) 住院人员和急诊室 (ED) 处置时间.
研究的目的:
- 评估个性化吞吐量指标对EM居民ED处置时间的影响.
- 确定是否提供特定的绩效数据会影响居民的效率.
主要方法:
- 从2021年1月到2022年12月进行了一项单中心,回顾性,观察性研究.
- 上级EM住院人员每月收到三个关键指标的报告:从房间到出院命令的时间 (Rm2Dc),结果到出院命令 (Rlts2Dc) 和房间到住院咨询命令 (Rm2Hosp).
- 使用独立的t测试和调整分析,比较了在计量报告之前和期间的处置时间.
主要成果:
- 在计量报告之前和期间,没有观察到平均处置时间 (Rm2Dc,Rlts2Dc,Rm2Hosp) 的总体显著差异.
- 小组分析显示,研究生第三年 (PGY-3) 居民的Rm2Hosp显著下降 (145.8分 vs. 124.1分,p=0.004).
- 经过调整后的分析证实了这些发现,显示处置时间没有显著的整体改善.
结论:
- 个性化吞吐量指标与高层EM居民平均ED处置时间的减少没有相关性.
- 在PGY-3居民住院患者的咨询时间显著改善 (平均减少21.7分钟).
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