一项旨在降低服务压力和改善内科医生健康的质量改善倡议
Jessica Evans1,2,3,4, Sydney Ruller5,6, Krista Wooller7,5,8,6
1Division of General Internal Medicine, Department of Medicine, The Ottawa Hospital, Ottawa, Canada. jesevans@toh.ca.
一个新的医院医师服务减少了临床教学单位 (CTU) 的人口普查和医生倦怠. 然而,增加的入院数量限制了这一影响,强调了需要多方面的方法来减少临床工作量和改善健康.
科学领域:
- 内部医学 内部医学
- 医疗保健管理的管理
- 医生健康 医生健康
背景情况:
- 医院压力会对医生的健康,教育和患者护理产生负面影响.
- 实施了非学术医院服务,以减少临床教学单位 (CTU) 普查的30%左右.
- 其次要目标包括评估医生/实习生的健康状况和患者不良结果.
研究的目的:
- 评估非学术医院服务对CTU人口普查的影响.
- 评估CTU上的医生和实习生健康状况.
- 确定干预是否导致患者意外的不良结果.
主要方法:
- 在2023年,在一个学术医院校园实施了两阶段干预.
- 在干预前和后收集了CTU人口普查,死亡率,再录取和逗留时间 (LOS) 的数据.
- 使用Mini-Z调查评估了医生健康状况,每季度分析数据.
主要成果:
- CTU人口普查下降,但在2023年第四季度上升,仍然低于干预前的水平.
- 在2023年第四季度 (p=0.033) 干预地点 (65.2%) 与非干预地点 (94.1%) 相比,医生倦怠率显著降低 (p=0.033).
- 倦怠与每日CTU人口普查正相关 (r=0.906);没有观察到死亡率,再入院或LOS的显著差异.
结论:
- 医院服务减少了CTU人口普查,改善了医生倦怠.
- 对服务压力的积极影响受限于增加入院人数.
- 需要多方面的策略来减少临床工作量和优化教学环境.
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