改进安全措施以减少ED返回的情况
Ghadah F Almugren1, Mufareh Al Katheri2,3,4, Ali M Al Khathaami4,5,6
1Quality and Patient Safety Department, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia ghadah.almugren@gmail.com.
BMJ open quality
|May 2, 2025
概括
一项质量改善计划显著减少了急诊室 (ED) 对危急患者的重复访问 46.60%. 建议进行持续监测,以进一步分析ED复发病例并改善患者的治疗结果.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 紧急医疗 紧急医疗
- 患者安全 患者安全
背景情况:
- 紧急部门 (ED) 返回病例,特别是涉及危急或已故患者的病例,对医疗保健组织来说是一个重大问题.
- 解决这些回访对于改善患者的结果和组织绩效至关重要.
研究的目的:
- 实施质量改善倡议,旨在将危急/已故成年患者在72小时内返回ED的次数减少50%.
- 评估导致入院或重访的因素,在ED出院后72小时内进行评估.
主要方法:
- 利用计划-做-研究-行动 (PDSA) 周期进行干预开发和实施,从2022年1月开始.
- 实施了每日系统性触发通知,并通过质量改进专家对ED复发病例进行了分析.
- 在回访后24小时内引入了患者安全领导会议,并将全面的咨询检查清单集成到医院信息系统 (HIS).
主要成果:
- 观察到ED复发患者的显著减少为46.60%,从2021年的0.13%降至2022-2023年的0.08%.
- 统计过程控制图表显示ED回归率持续改善.
结论:
- 质量改进倡议在降低与ED重访相关的患者发病率和死亡率方面非常有效.
- 虽然有效,但该倡议也导致不成熟入院的增加,强调需要持续监测和分析ED返回案件.
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