华盛顿州金县过量后接触计划的演变:通过持续质量改进学习的经验教训
Hannah N Collins1, Amy J Poel1, Jennifer Liu1
1Public Health - Seattle & King County, Seattle, Washington.
Prehospital emergency care
|September 4, 2024
概括
紧急医疗服务的外展计划帮助过量幸存者与护理联系. 持续质量改进 (CQI) 和计划-做-研究-行动 (PDSA) 周期完善了基于电话的外展模式,提高了效率并降低了每个转诊患者的成本.
科学领域:
- 公共卫生 公共卫生
- 紧急医疗 紧急医疗
- 成服务 成服务
背景情况:
- 过量服用后幸存者面临着随后过量服用和死亡的高风险.
- 过量服用后的外展计划旨在将幸存者与减少危害和治疗服务联系起来.
- 现有的计划在设计和有效性上有所不同.
研究的目的:
- 评估和改进华盛顿州金县的基于电话的过量后接触模式.
- 使用持续质量改进 (CQI) 过程来提高程序的质量.
- 通过代适应来评估计划指标和成本.
主要方法:
- 利用国王县紧急医疗服务 (KC-EMS) 记录来识别符合条件的患者.
- 实施了三个连续的计划-做-研究-行动 (PDSA) 周期,具有不同的外展策略和资格标准.
- 衡量计划指标和每月的成本,每位符合条件的患者,以及每位转诊患者.
主要成果:
- 最初的基于电话的试点项目有较低的推率 (2/月).
- 自动短信和扩大了第二阶段的资格,增加了转介 (3/月).
- 第三阶段实现了符合条件的患者 (405人/月) 和转诊 (4人/月) 的最高数量,并降低了每位转诊患者的成本 (279美元).
结论:
- CQI和PDSA周期有效地确定了适应措施,以提高外展计划的效率.
- 基于电话的过量后外展服务在患者转诊方面存在挑战.
- 该研究强调了CQI在计划运营中的价值,以及需要多方面的过量预防策略.
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