Yancer Deborah A, Foshee Debra, Cole Helen, Beauchamp Rebecca, de la Pena Will, Keefe Tom, Smith William, Zimmerman Kathryn, Lavine Marisa, Toops Barbara
Shady Grove Adventist Hospital, Rockville, Maryland, USA.
Jt Comm J Qual Patient Saf. 2006 May;32(5):239-45. doi: 10.1016/s1553-7250(06)32031-4.
Shady Grove Adventist Hospital implemented a series of housewide initiatives to decrease ambulance diversions, decrease wait times in the emergency department (ED), improve poor patient satisfaction, and decrease risks to patient safety.
Process improvement teams addressed areas affecting overcrowding and inpatient bed availability. Teams met to identify, test, and implement process changes. The ED's ability to evaluate, treat, and transfer patients requiring inpatient admission was identified as the most critical factor in reducing ED crowding and ambulance diversions.
From 2003 to 2004, the hospital reduced ambulance diversion hours from 2,365 to 655--a 72% reduction. It also decreased average in-hospital and ED lengths of stay, improved ED patient satisfaction scores, and decreased the number of patients "boarding" in the ED. Increases in the number of admissions and decreases in length of stay improved financial performance.
The initiatives helped improve access to care for the rapidly growing community. Reductions in ambulance diversions and ED overcrowding reflected a team effort, which included the executive team as well as clinical and nonclinical staff, and a holistic approach to identifying and removing throughput barriers.
树荫谷基督复临安息日会医院实施了一系列全院性举措，以减少救护车分流、缩短急诊科（ED）候诊时间、改善患者满意度低的问题，并降低患者安全风险。
流程改进团队处理了影响过度拥挤和住院床位可用性的领域。团队开会确定、测试并实施流程变更。急诊科评估、治疗和转运需要住院治疗患者的能力被确定为减少急诊科拥挤和救护车分流的最关键因素。
从2003年到2004年，医院将救护车分流时间从2365小时减少到655小时，减少了72%。同时缩短了平均住院时间和急诊科停留时间，提高了急诊科患者满意度评分，并减少了在急诊科“滞留”的患者数量。入院人数的增加和住院时间的缩短改善了财务状况。
这些举措有助于改善快速增长社区的医疗服务可及性。救护车分流和急诊科过度拥挤情况的减少反映了团队的努力，其中包括行政团队以及临床和非临床工作人员，以及一种识别和消除流程障碍的整体方法。
