通过在ICU中实施一套核心质量指标来减少行政负担:一个多中心纵向干预研究
Gijs Hesselink1, Rutger Verhage2, Brigitte Westerhof3
1Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands Gijs.Hesselink@radboudumc.nl.
BMJ quality & safety
|August 30, 2024
概括
减少重症监护病房 (ICU) 质量指标的数量,大大减少了临床医生的记录时间和行政任务. 这一变化没有影响患者的护理质量,以标准化的死亡率和再入院率来衡量.
科学领域:
- 医疗保健管理的管理
- 改善临床质量 改善临床质量
- 密集护理医学 密集护理医学
背景情况:
- 越来越多的数据记录要求重症监护室 (ICU) 的质量指标.
- 对众多质量指标的有效性表示担忧.
- 需要简化ICU专业人员的行政负担.
研究的目的:
- 评估基于共识的核心质量指标是否能减少ICU的文件处理时间和行政负担.
- 评估一组核心指标对ICU专业人员工作快乐的影响.
- 确定是否使用一组核心指标会影响ICU护理的质量,特别是标准化死亡率 (SMR) 和ICU再接收率.
主要方法:
- 一项从2021年5月到2023年6月在七家荷兰医院进行的纵向研究.
- 只有ICU临床医生记录了一组核心质量指标的数据.
- 经过验证的问卷调查评估了在三个时间点上花费于文件的时间,行政负担和工作乐趣.
- 从荷兰国家重症监护登记处收集了标准化死亡率和ICU再入院率.
主要成果:
- 在最后一个时间点,每天的文档处理时间减少了30分钟 (p<0.01).
- 受访者报告说,不必要和不合理的行政任务显著减少 (p<0.01).
- 在研究期间,没有观察到工作快乐,标准化死亡率或ICU再入院率的显著变化.
结论:
- 实施一套核心质量指标有效地减少了ICU临床医生的文件处理时间和行政负担.
- 减少行政任务并没有对患者的结果产生负面影响,稳定的SMR和ICU再接收率证明了这一点.
- 节省时间为改善患者护理和改善ICU环境中的工作满意度提供了机会.
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