通过综合老年医学评估解决外科等待名单问题
Karina James1, David Burberry1, Duncan Soppitt2
1Consultant Geriatrician, Swansea University Health Board, Morriston Hospital, Swansea, UK.
Future healthcare journal
|July 18, 2025
概括
一个新的手术等候名单分类系统显著减少了患者人数,特别是等待胆囊切除术的老年人. 这种方法,使用全面的老年医学评估和共享决策,提供了一个可持续的模式,以改善手术患者的护理和结果.
科学领域:
- 老年医学 老年医学
- 手术患者护理手术患者护理
- 医疗保健管理的管理
背景情况:
- 手术等候名单越来越多,不成比例地影响老年人和贫困地区的人.
- 糟糕的共享决策 (SDM) 有助于医疗保健成本和诉讼.
- 对接受手术的老年人 (POPS) 模型的术后护理提供了潜在的解决方案.
研究的目的:
- 将POPS原则纳入老年手术患者的常规护理,员工数量最小.
- 描述胆囊切除术等候名单和患者经验.
- 通过对脆弱个体进行全面的老年病学评估,提供SDM.
主要方法:
- 为等待胆囊切除术的64岁以上患者提供双层分拣系统 (邮政和电话).
- 针对所有患者的多学科团队讨论.
- 提供给患有虚弱 (CFS>5) 的患者的临床预约.
- 关于诊断,干预和查方法的前性数据收集.
主要成果:
- 65岁以上患者的平均等待时间为101.7周.
- 在接受调查的98名患者报告说,他们的健康状况在等待期间恶化.
- 32.8%的人符合脆弱性标准;44人获得诊所预约.
- 51名患者 (19.9%) 通过分拣从等待名单中删除.
- 超过一半的移除患者通过非临床人员的简单干预来确定.
结论:
- 一种分组方法有效地减少了等待胆囊切除术的老年人等候名单.
- 简单的干预措施和非临床人员的参与可以显著影响等候名单的数量.
- 这种模式对管理长期的外科等待列表产生了重大影响,特别是在高风险的老年人群中.
- 新的方法可以提高可持续性,患者护理和外科手术服务的结果.
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