改善急救部门登机时间:平衡效率和安全
Adam A Vukovic1,2,3, Tricia Purcell4, Stephanie Thomas2,5
1Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatrics
|December 16, 2025
概括
通过流程改进,紧急部门登机时间减少了40%. 这提高了患者流动和护理准入,证明了医院运营中的成功干预.
科学领域:
- 医疗保健操作 医疗保健操作
- 提高质量 提高科学 提高质量
- 患者流量管理患者流量管理
背景情况:
- 紧急情况 (ED) 部门的拥挤和延长的登机时间显著降低了患者护理质量.
- 患者入院过程中的低效率导致ED登机时间延长.
- 优化患者从ED到住院 (IP) 单位的过渡对于医疗保健提供至关重要.
研究的目的:
- 在24个月内将入院患者的平均ED登机时间减少35%.
- 识别和解决ED-to-IP录取过程中的系统性低效.
- 改善医院系统内的整体患者流动和护理准入.
主要方法:
- 利用改善模型框架和关键驱动图来指导干预.
- 实施了连续的计划-做-研究-行动 (PDSA) 周期,用于代测试和改进过程变化.
- 集中干预措施是加强共享流程知识,知识产权室准备,利益相关者沟通和入学简化.
- 采用统计过程控制图表来监控ED登机时间,ED停留时间 (LOS),非常快速的转移率和没有被看到的离开 (LWBS) 率.
主要成果:
- 平均ED登机时间减少了40%,从169分钟减少到102分钟.
- 观察到ED停留时间 (LOS) 和没有被看到 (LWBS) 率的同时下降.
- 在非常快速的转移率中保持稳定,表明对重症监护准入没有不利影响.
结论:
- 机构和现场领导层的持续参与对于项目成功至关重要.
- 对理解和优化招生流程的系统方法导致了显著的改进.
- 精简的沟通和明确的流程时间表有效地改善了护理和ED操作的过渡.
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