增加一名医疗实习生到急诊室夜班的影响
Asaf Haim Glass-Biran1, Andrew Eyre2, Gidon Stein2
1Internal Department A, Meir Medical Center, Kefar Sava, Israel glassas@gmail.com.
BMJ open quality
|February 2, 2026
概括
将第四名医生加入急诊室夜班并没有改善关键绩效指标. 虽然住院率略有下降,但患者处置时间增加,这表明急诊室效率没有显著提高.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 临床操作 临床操作
背景情况:
- 紧急服务部门 (ED) 在管理患者流动和效率方面面临挑战.
- 优化医生人员配置对于改善患者护理和操作结果至关重要.
研究的目的:
- 为了确定是否增加ED夜班的医生人员数量会影响关键绩效指标.
- 评估额外的医生对患者处置时间和入院率的影响.
主要方法:
- 追溯队列研究分析了从2021年1月到2023年5月的ED数据.
- 在2021年9月实施第四名夜班医生之前和之后的结果进行了比较.
- 评估了主要结果,包括与医生接触的时间,处置的时间,以及住院率,一天住院率和复诊率.
主要成果:
- 住院治疗率出现了很小的下降 (44%至42%,p=0.03),而一天住院治疗率则增加 (26%至28%,p=0.006).
- 奇怪的是,处置时间略有增加,从4.5小时增加到4.7小时 (p<0.001).
- 没有观察到回访率或第一次与医生接触的时间发生显著变化.
结论:
- 增加ED夜班的医生人员数量并没有显著改善整体效率指标.
- 增加一名医生并没有导致患者流动或关键绩效指标的实质性改善.
- 一个潜在的好处是减少了每个医生的患者负担,可能减轻了个人的工作负担.
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