紧急部门直接到临终医院出院:简化转诊计划的纵向评估
Daniel W Markwalter1, Jared Lowe2, Ming Ding3
1Department of Emergency Medicine, University of North Carolina at Chapel Hill School of Medicine, 170 Manning Drive, CB# 7594, Chapel Hill, NC 27599-7594, USA; UNC Palliative Care and Hospice Program, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Drive, Chapel Hill, NC 27514, USA.
The American journal of emergency medicine
|September 27, 2024
概括
质量改进计划没有显著增加直接的急诊部 (ED) 到临终关怀的过渡. 需要进一步的研究来改善患者鉴定和临终关怀协调.
科学领域:
- 提高质量 提高质量
- 抚慰性护理是一种缓解性护理.
- 紧急医疗 紧急医疗
背景情况:
- 80%的美国人更愿意在医院外死亡,因此临终关怀是必不可少的.
- 紧急诊所 (ED) 对于识别需要终身护理的患者和促进住院接入至关重要.
- 本研究分析了一项质量改进 (QI) 计划,以增加ED-to-hospice直接转诊.
研究的目的:
- 评估一项旨在增加ED的直接临终关怀转诊的QI计划.
- 评估该计划对每月ED-to-hospice病例和转移的影响.
- 为了确定对急诊室停留时间 (LOS) 的影响.
主要方法:
- 实施了QI计划,包括工作流程简化,员工教育和电子医疗记录 (EMR) 工具.
- 追踪每月的ED-to-hospice病例和实施前后的转移发病率.
- 作为次要结果,分析了ED逗留时间 (LOS).
主要成果:
- 在研究期间,共有202名患者从ED转移到宿舍.
- 该QI计划显示,平均每月ED-to-hospice病例 (3.16至3.47) 的轻微,非显著增加.
- 从ED转移到宿舍的发病率或ED LOS的发病率没有明显变化.
结论:
- 一个专注于工作流程,教育和EMR工具的QI计划并没有显著增加直接ED-to-hospice出院的数量.
- 这是迄今为止关于ED-to-hospice直接出院的最大研究.
- 未来的努力应集中在患者识别,医院临终关怀的影响和家庭终身护理的护理协调上.
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