通过优化保险预先授权来减少辐射瘤学的患者护理延迟
Maxwell Tran1, Bhisham Chera1, Kevin Shrake1
1Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina.
Practical radiation oncology
|November 4, 2024
概括
通过优化临床治疗计划 (CTP) 文件和工作流程,简化放射治疗的保险预授权 (preauth),大大减少了延误和拒绝. 这通过确保及时获得放射治疗来改善患者护理.
科学领域:
- 辐射瘤学 辐射瘤学
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 保险事先授权的延迟可能会阻碍患者及时获得放射治疗.
- 临床治疗计划 (CTP) 完成和预先授权过程中的工作流失效率导致了这些延误.
- 优化这些流程对于改善患者护理和治疗提供至关重要.
研究的目的:
- 在放射性瘤学中对保险预授权延误进行根本原因分析.
- 实施工作流程解决方案,旨在减少CTP完成时间和预先授权延迟.
- 将CTP平均完成时间和延迟/拒绝案件的百分比降低50%.
主要方法:
- 使用了Plan-Do-Study-Act和A3质量改进方法来进行根本原因分析.
- 优化了CTP模板,其中包含了预先授权所需的疾病特定信息.
- 在部门的护理路径中正式化了早期的CTP完成和预授权工作流程.
主要成果:
- 平均CTP完成时间从16天减少到4天 (P < .001).
- 平均保险预授权启动到完成时间从5天提高到1天.
- 延迟/拒绝病例的百分比从32%大幅降至8% (P < .001).
结论:
- 优化的CTP文档和预授权工作流程提高了效率.
- 实施护理路径和改进的CTP模板导致减少了保险预授权延误和拒绝.
- 这些改进确保为患者提供更及时,更有效的放射治疗.
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