促进在儿童尾切除术后使用当天排泄:实施基于证据的术后途径
Radek Buss1, Emmanuel L Abebrese2, Kathleen Leack2
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
American journal of surgery
|July 8, 2025
概括
在实施新途径后,儿科尾炎的同日出院 (SDD) 显著增加. 这种方法可以减少住院时间和费用,而不会影响患者的安全或再入院.
科学领域:
- 儿科手术 儿科手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 腹腔镜尾切除术后的当日出院 (SDD) 与减少住院时间和费用有关.
- 在一家儿童医院对患有无并发性尾炎 (UA) 的儿童实施SDD途径进行了研究.
- 该研究旨在增加SDD利用率,同时考虑到COVID-19相关的变化.
研究的目的:
- 详细介绍儿童无并发性尾炎新SDD途径的实施情况.
- 评估该路径对SDD利用的影响.
- 在COVID-19大流行期间评估安全和效率结果.
主要方法:
- 精益六西格玛 (Lean Six Sigma) 方法被用来确定影响SDD利用的因素.
- 一个多学科团队在2021年4月开发并实施了一种新的术后途径.
- 途径的有效性在2022年4月重新评估.
主要成果:
- 在1258名儿童中,SDD使用率从51.8%增加到82.8% (p < 0.001).
- 医院费用减少了873美元,住院时间减少了5.7小时 (p < 0.001).
- 没有观察到再入院或急诊室访问的增加;经过调整后,SDD的几率增加了76% (p < 0.001).
结论:
- 一个新的基于证据的途径成功地增加了小儿非复杂尾炎中SDD利用率.
- 该途径的实施是安全和有效的,即使在COVID-19大流行期间.
- 这种方法为降低医疗保健成本和提高儿科手术效率提供了一个模型.
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