实践是否与协议相匹配? 一个比较的 triage-to-provider 时间在更多与不那么急性急诊室患者之间的比较
Temesgen T Tsige1, Rida Nasir1, Daisy Puca1
1Department of Emergency Medicine, Long Island Jewish Medical Center, Northwell Health, Long Island, USA.
Cureus
|September 4, 2024
概括
在急诊室,分流模式可能会导致不那么急性患者在更急性患者之前被看病,这可能会推迟关键护理. 需要进一步的研究才能充分了解对患者结果的影响.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健操作 医疗保健操作
- 患者流量管理患者流量管理
背景情况:
- 紧急严重性指数 (ESI) 对于在急诊室 (ED) 中分层患者至关重要.
- 在ED的分流模型中,以不同的护理途径将不那么急性 (ESI 4-5) 和更急性 (ESI 1-3) 患者分开.
- 紧急医疗的核心原则是优先考虑最急性患者.
研究的目的:
- 为了确定不那么急性患者的百分比,医疗服务提供者看到的急性患者比接近在一起的急性患者更早.
- 在分割流模型中,比较快速跟踪和急性护理区域之间的分拣到提供者的时间.
主要方法:
- 分析了252名成年ED患者的随机样本.
- 收集的数据包括ESI水平,分组时间,首次提供者注册时间和患者位置 (快速跟踪与急症护理).
- 基于ESI,位置和等待时间,对比了具有相似到达时间的双对患者.
主要成果:
- 在39.4%的高与低急性患者中,较不急性患者首先被观察到.
- 急症护理区域的患者通常比快速通道区域的患者有更短的分诊时间.
- 在快速通道中的ESI 3患者中,大约三分之一在急症护理中的ESI 2患者之前被观察到.
结论:
- 虽然分流模型提高了ED的效率,但它们可能会损害优先考虑急性患者的原则.
- 很大一部分不那么急性患者在更急性患者之前就诊,这可能会影响紧急护理.
- 快速通道区域可能无法按预期运行,一些患者的等待时间比预期更长.
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