评估工作量和临床医生的经验对患者吞吐量的影响:一个多中心研究
Marisha Burden1, Venkat P Gundareddy2, Regina Kauffman2
1Division of Hospital Medicine, University of Colorado, Aurora, Colorado, USA.
Journal of hospital medicine
|November 26, 2024
概括
通过笔记数来衡量医生的工作量,增加了复杂病例的患者逗留时间 (LOS). 然而,医生经验增加与较短的LOS有关,为医院效率提供了洞察力.
科学领域:
- 医疗保健管理的管理
- 临床操作 临床操作
- 医疗信息学 医疗信息学
背景情况:
- 住院时间 (LOS) 是一个由各种因素影响的关键指标.
- 现有的减少LOS的策略显示出可变的有效性.
- 工作设计和医生经验是 LOS 的潜在关键决定因素.
研究的目的:
- 为了验证电子笔记计数作为工作负载指标.
- 评估医生工作量,患者复杂性和LOS之间的关系.
- 评估医生经验对LOS的影响.
主要方法:
- 在三个学术医院进行了回顾性观察性研究.
- 从医院医学医生及其患者收集的数据.
- 通过电子笔记计数测量工作量;通过查尔森并发症指数 (CCI) 测量患者的复杂性;医生经验根据培训以来的年份.
主要成果:
- 在早晨人口普查和笔记计数之间发现了适度的相关性 (r=0.56),但与LOS没有直接关联.
- 医生工作量 (注释数) 显著增加了中度 (2.3%) 和重度 (3.9%) CCI.患者的LOS.
- 每增加一年的医生经验都与0.7%的LOS下降有关.
结论:
- 医生工作量,以笔记数表示,与增加的LOS相关,特别是在具有较高并发症分数的患者中.
- 更大的医生经验与减少的LOS有关,这表明有保护作用.
- 电子笔记计数可以作为工作负载指标,特别是在考虑患者的复杂性时.
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