实施高风险血管外科手术患者的初级保健随访
Elizabeth Ford1, Suzanna Fitzpatrick1, Sarah Rosenberger1
1University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA.
一个质量改进项目通过提供及时的初级保健提供者 (PCP) 随访,减少了高风险血管手术患者的30天住院再诊. 接受干预的患者的再入院率为21.4%,而没有接受干预的患者的再入院率为30.4%.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者研究成果研究结果
- 血管外科 血管外科
背景情况:
- 医疗保险和医疗补助服务中心 (CMS) 确定30天的住院再接收率作为一个关键的结果指标.
- 高回收率与医疗保健成本增加和医院病床利用率的增加有关.
研究的目的:
- 为了减少高风险血管外科手术患者在家出院的非计划的30天住院再诊.
- 在一个学术医疗中心的血管外科部门内实施一个有针对性的质量改善 (QI) 计划.
主要方法:
- 一个"再入院医院评分"工具确定了高风险患者.
- 干预措施涉及在退院后两周内与初级保健提供者 (PCP) 进行后续检查.
- 一个过渡期护理诊所为缺乏PCP或无法及时预约的患者提供护理.
主要成果:
- 在158名出院的血管外科手术患者中,有19%的患者经历了未计划的30天再入院.
- 接受干预的高风险患者的再入院率为21.4%,而未接受干预的患者的再入院率为30.4%.
- 在工作人员中发现了干预的坚持挑战.
结论:
- PCP和过渡期护理诊所的访问解决了急性和慢性医疗问题,可能减少再入院.
- 过渡期护理诊所的使用增加凸显了患者对PCP机构的持续需求.
- 未来的流程变化是必要的,以确保成功的患者过渡和护理连续性.
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