负载平衡作为提高紧急部门吞吐量的策略
Monisha Dilip1, Huifeng Su2, Weiheng Zhang2
1Department of Emergency Medicine, Columbia University Medical Center, New York, NY, USA.
The American journal of emergency medicine
|September 4, 2025
概括
负载平衡,在医院校区之间转移患者,显著减少急诊室 (ED) 的登机时间. 这一战略改善了医院系统中的病人流动和容量,
科学领域:
- 医疗服务研究
- 医院运营管理
- 紧急医疗
背景情况:
- 紧急部门 (ED) 拥挤是一个关键的国家医疗保健问题.
- 患者负载平衡,即医院校区间的患者转移,旨在重新分配容量.
- 负载平衡对ED吞吐量和运营的影响需要进行彻底评估.
研究的目的:
- 从转移患者的角度评估患者负载平衡对ED吞吐量的影响.
- 评估单一卫生系统内的负载平衡的运营效益和缺点.
- 分析负载平衡患者的登机时间和住院时间.
主要方法:
- 在单一卫生系统内对两个ED进行了回顾性观察研究.
- 对42,046例入院病人的分析,将患者分为负载等级 (转移) 或同一校区的入院群体.
- 主要结果:登机时间和住院时间;次要结果:ED吞吐量指标.
主要成果:
- 负载平衡患者的登机时间显著缩短 (减少7. 8小时).
- 两组之间没有观察到住院时间的显著差异.
- 负载平衡减少了门到房间的时间和患者离开未被看到的风险.
结论:
- 负载平衡有效地减少ED登机时间,提高入院患者的容量.
- 这一策略是医院系统改善整体患者吞吐量的宝贵工具.
- 实施负载平衡可以缓解ED拥挤的日益严重的挑战.
相关概念视频
Planning Nursing Care I
4.7K
The planning phase of the nursing process helps nurses set priorities, outline patient-centered goals and expected outcomes, and tailor nursing interventions to align with the aligned care plan. Through the planning phase, the nurse applies critical thinking skills to align and develop interventions according to the patient's needs. It provides continuity of care allowing patients to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual staff to a...
4.7K
Heart Failure V: Medical Management
23
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
23
Rational Dosage Regimen: Maintenance Dose and Loading Dose
4.4K
A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady...
4.4K
Heart Failure VII: Nursing Interventions
139
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
139
Heart Failure VI: Adjunct Therapies
27
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
27
Cardiopulmonary Resuscitation IV: Pharmacological Management
75
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
75


