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在紧急医疗住院培训期间提高生产力和效率
Matthew T Singh1,2, David M Austin2, Stephanie C Mullennix3
1Corewell Health/Michigan State University College of Human Medicine, Grand Rapids, Michigan.
The western journal of emergency medicine
|March 27, 2025
概括
紧急医疗人员在三年内改善了患者的吞吐量,第二年每小时见病率 (PPH) 停滞. 门到决策时间 (DTDT) 在整个住院培训过程中持续改善.
科学领域:
- 医学教育 医学教育
- 紧急医疗 紧急医疗
- 医疗保健分析 医疗保健分析
背景情况:
- 紧急医疗 (EM) 居民培训强调安全的毕业后实践的效率和生产力.
- 多任务是研究生医学教育认证委员会 (ACGME) 的一个关键里程碑,通常通过观察来评估.
- 定量指标,如每小时看病率 (PPH),可以增强住院人员的培训和经验.
研究的目的:
- 使用定量数据分析居民生产力和效率趋势.
- 定义居民PPH随时间推移的学习曲线.
- 调查额外的吞吐量指标,如门到决策时间 (DTDT),以及它们与培训进展的关系.
主要方法:
- 在一个繁忙的第三级护理急诊室 (ED) 进行了回顾性观察性研究.
- 分析包括42名居民和79,232名成年患者超过30个月 (2019年7月至2021年12月).
- 用指数回归模型来评估PPH,并对患者共变量和研究生年 (PGY) 进行调整.
主要成果:
- 在研究期间,PPH中位数从0.898增加到1.425.
- 根据PGY的PPH中位数为1.13 (PGY 1),1.38 (PGY 2) 和1.38 (PGY 3),表明第二年出现了平原.
- 中位数DTDT逐渐改善:185分钟 (PGY 1),171分钟 (PGY 2) 和166分钟 (PGY 3).
结论:
- 居民PPH在整个EM培训过程中得到改善,但在研究生第二年趋于平稳.
- 门到决策时间 (DTDT) 在所有三年居住期间都表现出持续改善.
- 这些定量指标对于评估和提高居民绩效和ED运营效率至关重要.
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