使用质量改进方法来减少英国监狱内的医疗保健的"没有出席"情况
Nitish Lakhman1, Suzan Harleston2, Emma Knight2
1Oxleas NHS Foundation Trust, Dartford, Kent, UK nitish.lakhman@nhs.net.
BMJ open quality
|March 31, 2025
概括
一个妇女监狱的质量改进项目显著降低了不出席 (DNA) 率,每周从21%降至3%. 这一举措提高了效率,降低了成本,并取得了持续的成果,证明了在惩戒机构中有效的医疗保健管理.
科学领域:
- 医疗保健管理的管理
- 提高质量 提高质量
- 惩戒医疗保健 惩戒医疗保健 惩戒医疗保健
背景情况:
- 陛下监狱东萨顿公园在五个核心医疗保健诊所面临每周21%的不出席率.
- 监狱中的高DNA率增加了等待时间,浪费成本,并阻碍了资源管理.
- 与社区服务相比,监狱设置在管理医疗保健DNA方面存在独特的挑战.
研究的目的:
- 实施一个质量改进项目,以减少和维持医疗保健的不出席率 (DNA) 在妇女监狱内低于10%.
- 为了应对在惩戒医疗环境中管理DNA的独特挑战.
- 提高监狱医疗保健服务的效率和资源管理.
主要方法:
- 利用改善模式框架,包括明确的目标,措施和通过计划-做-研究-行动周期测试的变化想法.
- 强调医疗保健团队和监狱工作人员之间的合作伙伴关系.
- 员工使用统计过程控制图表来监测结果措施和跟踪改进.
主要成果:
- 每周DNA减少了86%,从21%降低到3%.
- 减少了76%的临床时间浪费 (每周从284分钟减少到66分钟),减少了67%的成本浪费 (每周从303英减少到99英).
- 这些改善持续超过35周,证明了长期的有效性.
结论:
- 标准化流程和系统变革理念,包括加强患者参与和监狱伙伴关系,显著减少了DNAs.
- 该项目带来了医疗保健诊所效率和资源利用的持续改善.
- 在项目的持续时间内,没有观察到患者对医疗保健的投诉增加.
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