简化紧急部门的工作流程:减少停留时间,减少因拥堵引发的常务订单
Saied Samiedaluie1, Vera Tilson2, Armann Ingolfsson3
1Alberta School of Business, University of Alberta, 11211 Saskatchewan Drive NW, Edmonton, T6G 2R6, Alberta, Canada. samiedal@ualberta.ca.
Health care management science
|April 26, 2025
概括
在急诊室 (ED) 的常务订单可以改善患者流动,但需要仔细管理. 基于ED拥堵的新门政策优化了常务订单的使用,以减轻过度测试等风险并确保系统效率.
科学领域:
- 医疗保健 运营 研究 研究 研究
- 紧急医疗管理管理
- 临床工作流程优化 临床工作流程优化
背景情况:
- 常设订单使分拣护士能够在急诊室 (ED) 医生评估之前订购测试.
- 目前的常务命令缺乏操作指南,可能导致系统效率低下和患者意外后果.
- 优化使用常务订单对于改善ED吞吐量和患者护理至关重要.
研究的目的:
- 检查常务命令对整个ED系统的运营影响.
- 根据ED拥堵水平,提出和评估激活常规订单的门政策.
- 识别和减轻执行常务命令的潜在意外后果.
主要方法:
- 开发了三个简化的模型:无限服务器,杰克逊网络和马尔科夫决策过程.
- 使用分析模型和仿真对值政策进行参数化.
- 对模拟模型与真实世界ED数据进行校准以进行验证.
- 分析ED停留时间 (LOS) 和全系统运营影响.
主要成果:
- 一个门政策,作为一个简单的拥堵依赖的规则,表现出各种参数的强大表现.
- 常规可以导致不同患者群体的不同结果,并可能导致过度测试或溢出效应.
- 拟议的政策有效地平衡了针对目标患者减少LOS的好处,并考虑了全系统的运行考虑.
结论:
- 对常务订单实施基于拥堵的门政策可以优化其在ED中的使用.
- 需要仔细考虑运营条件,以最大限度地提高效益,并最大限度地降低与常务订单相关的风险.
- 进一步研究临床干预的全系统影响,如常务命令,对于有效的医疗保健提供至关重要.
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