通过标准化出院途径改善神经学和医学服务的患者流动
Colin M McCrimmon1, Molly R Fensterwald1, Linda K Czypinski2
1Department of Neurology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
BMJ open quality
|August 22, 2025
概括
一种新的标准化排泄途径提高了短暂缺血性发作,,脱髓性疾病或昏迷的患者的医院效率. 这项质量改善举措显著减少了出院时间和停留时间,提高了患者流动.
科学领域:
- 医疗管理
- 提高质量
- 临床途径
背景情况:
- 退院计划不良会对医院的运转量,财务状况以及患者/医疗服务提供者的满意度产生负面影响.
- 失效的出院流程增加了医疗保健系统的压力.
研究的目的:
- 为四种常见诊断制定和评估基于共识的排放框架和标准化途径.
- 评估干预对出院时间和停留时间的影响.
主要方法:
- 专家的共识被用来生成暂时性缺血性发作,,脱髓性疾病和昏迷的医疗准备条件.
- 实施了一种标准化的排放途径,并在干预前后跟踪排放时间和再接收.
- 主要结局:60%的患者达到2小时以上的出院时间;次要结局:减少出院时间 (TTD) 和LOS.
主要成果:
- 中位数TTD从171分钟降至88-92分钟;中位数LOS从94小时降至30-35小时.
- 所有主要和次要结果都得到满足和维持.
- 三十天的急诊室访问和再接收仍然很低 (约1.5%),提供者的工作流程有所改善.
结论:
- 一个标准化的出院框架显著提高了四种常见诊断的患者的效率.
- 实施的框架具有可扩展性,为寻求提高患者吞吐量的其他医院提供了价值.
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