收集"圆":一个集成的护理模式的急诊室多次访问的病人
April Feld1,2,3,4,5,6,7,8,9,10,11,12,13, Matt Carollo1,2,3,4,5,6,7,8,9,10,11,12,13, Jere Freeman-Reyes1,2,3,4,5,6,7,8,9,10,11,12,13
1April Feld, DNP, RN, NEA-BC, CCM, CPHQ , is the Director of Ambulatory Care Management for the Clinically Integrated Network at Stony Brook Medicine.
多次访问患者 (MVP) 计划通过综合护理解决复杂的医疗,行为和社会需求,使高使用患者的急诊室 (ED) 访问减少了57%. 这一倡议突出了病例管理人员在优化患者治疗结果和减少ED利用方面的关键作用.
科学领域:
- 医疗保健管理的管理
- 公共卫生 公共卫生
- 临床干预 临床干预
背景情况:
- 紧急部门 (ED) 面临着每年超过1.3亿次访问的巨大压力,非紧急病例导致拥挤和护理延误.
- 高使用ED患者通常具有复杂的,未满足的医疗,行为和社会需求,这些需求超出了紧急护理范围.
- 多次访问患者 (MVP) 计划是为了满足经常使用ED的患者的需求而开发的.
研究的目的:
- 实施和评估综合护理模式,即MVP计划,旨在减少高频率访客中急诊室 (ED) 的使用.
- 识别,参与和干预患者在12个月内展现5次或更多ED访问.
- 通过解决潜在的复杂需求来改善患者的稳定性,健康和整体健康结果.
主要方法:
- 该MVP计划利用ED领导和病例管理 (CM) 的跨学科团队来识别和参与高使用率的患者.
- 患者接受了包括抑郁症,跌倒风险,酒精使用障碍,护理人员支持和健康的社会决定因素在内的疾病的全面查.
- 干预措施包括将患者与门诊专家和社区组织联系起来.
主要成果:
- 在20个月的时间里,确定了221名高使用率的患者,89%的患者成功联系,78%的患者参与了该计划.
- 在151名患者中,具有完整的参与和利用数据,ED访问减少了57%.
- 病例经理在协调护理和解决患者需求方面发挥了关键作用.
结论:
- 通过提供全面,综合的护理,MVP计划有效地减少了高频率患者的ED利用率.
- 病例经理对于识别和解决复杂患者群体的多方面的需求至关重要.
- 该模型展示了优化患者护理和减少急诊室负担的成功策略.
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