Meyer Mark A, Sokal Suzanne M, Sandberg Warren, Chang Yuchiao, Daily Bethany, Berger David L
Laboratory of Computer Science, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
J Surg Res. 2006 May 15;132(2):153-8. doi: 10.1016/j.jss.2006.02.055.
Capacity constraints necessitate improving hospital efficiency. An integrated real time system facilitating patient flow between the post-anesthesia care unit (PACU) and surgical ward would ease PACU workload by reducing the effort of discharging patients.
We developed INCOMING!, a web-based platform that monitors patient progress from the operating room to the PACU. INCOMING! integrates available data, automatically determining when a patient enters the PACU. An automated paging system alerts clinical unit managers to 'pull' their patients from the PACU after a set recovery period. General surgery patients were included in the INCOMING! system in late 2004 with paging added in mid-March 2005. Mean PACU length of stay was calculated for the intervention group (general surgery patients with INCOMING!) and compared to a control group (general surgery patients without INCOMING!) and an orthopedic surgery group before and after paging.
The system successfully gathers data and generates automated pages when events occur. After paging, there was a significant difference between the orthopedic surgery control group and the general surgery intervention group (235 min versus 185 min, P = 0.001). The mean PACU LOS decreased in the INCOMING! intervention group by 26 min while the mean LOS increased by 28 min in the general surgery control group (P = 0.27).
Pilot implementation demonstrates that INCOMING! performs the desired integration and automatic notification. Given the minimal cost and potential large gains from a wider deployment, we plan to implement the system for all PACU patients and all post-PACU care units.
容量限制使得提高医院效率成为必要。一个促进患者在麻醉后护理单元（PACU）和外科病房之间流动的集成实时系统，将通过减少患者出院的工作量来减轻PACU的负担。
我们开发了INCOMING!，一个基于网络的平台，用于监测患者从手术室到PACU的进展情况。INCOMING!整合可用数据，自动确定患者何时进入PACU。一个自动传呼系统会提醒临床科室管理人员在设定的恢复期后从PACU“接回”他们的患者。普通外科患者于2004年末被纳入INCOMING!系统，并于2005年3月中旬增加了传呼功能。计算了干预组（使用INCOMING!的普通外科患者）的平均PACU住院时间，并与对照组（未使用INCOMING!的普通外科患者）和骨科手术组在传呼前后进行了比较。
该系统成功收集数据并在事件发生时生成自动传呼。传呼后，骨科手术对照组和普通外科干预组之间存在显著差异（235分钟对185分钟，P = 0.001）。INCOMING!干预组的平均PACU住院时间减少了26分钟，而普通外科对照组的平均住院时间增加了28分钟（P = 0.27）。
试点实施表明INCOMING!实现了预期的集成和自动通知。鉴于成本最低且广泛部署可能带来巨大收益，我们计划为所有PACU患者和所有PACU后护理单元实施该系统。
