扩大急性护理治疗和处置选择:创建一个后ED快速诊所随访计划
Doug Wallace1, Chetan Aher2, Patty Wright3
1Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
The American journal of emergency medicine
|May 1, 2025
概括
一个快速的急救部门 (ED) 后续计划安全地避免了75%的转诊患者入院. 这个倡议为医疗保健系统提供了可行的解决方案,这些医疗保健系统面临ED能力挑战.
科学领域:
- 医疗保健管理的管理
- 紧急医疗 紧急医疗
- 医疗保健服务研究 医疗服务研究
背景情况:
- 全国各地的医院正在经历急剧增加的急诊室 (ED) 抵达,导致严重的容量挑战.
- 患者登机在EDs是一个关键问题,由容量限制加剧.
- 需要有效和安全的替代患者安排来解决ED能力和登机危机.
研究的目的:
- 评估新型急救部门 (ED) 快速后评估和后续计划的有效性和安全性.
- 确定门诊随访预约是否可以作为ED患者入院的安全替代方案.
- 评估该计划对医院容量和患者流量的影响.
主要方法:
- 实施一个企业范围的,协作性的快速后ED评估和后续过程.
- 实时,不依赖付款人安排ED患者的门诊随访预约 (初级保健和子专业).
- 由医生监督领导者进行回顾性审查,以确定是否避免了入院.
主要成果:
- 在12个月的时间里,有735个转诊,有551个 (75%) 的预约避免了住院.
- 超过80%的患者完成了预定的随访预约.
- 3.5%的患者 (26/735) 在七天内接受了随后的访问;没有人需要进入重症监护室或中等护理单位.
结论:
- 快速的ED后诊所随访计划成功为数百名患者提供了住院的安全替代方案.
- 该计划有效地减少了ED登机时间,改善了患者流动.
- 面临能力挑战的医疗保健系统可以考虑实施类似的个性化快速后续计划.
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