Takakuwa Kevin M, Shofer Frances S, Abbuhl Stephanie B
Thomas Jefferson University, Department of Emergency Medicine, Philadelphia, Pennsylvania 19107-5004, USA.
J Emerg Med. 2007 May;32(4):337-42. doi: 10.1016/j.jemermed.2006.07.031.
The objective of this study was to determine if the implementation of bedside registration would affect patient throughput times in an urban, academic emergency department. This was a before-and-after interventional study. An 8-month period before initiating bedside registration in November 2001 was compared to three subsequent 4-month intervals. Four times of day and three triage classifications were examined. Data were analyzed using a three-way analysis of covariance. There were 58,225 patient encounters analyzed. There was a significant difference in time from triage to room after bedside registration began (p < 0.0001). When examined by triage class, there were no differences in triage-to-room for emergent patients, a significant decrease for urgent patients initially and a significant decrease for non-urgent patients. Bedside registration by time of day initially reduced all four time-of-day periods but over the year they returned to pre-bedside registration levels, except for the morning period. Bedside registration decreased triage-to-room times for non-urgent patients and urgent patients initially, but this was not sustained at the end of 1 year. It had no effect on emergent patients who are routinely taken into the patient care area immediately. The sustainable effects of bedside registration were during the morning time when emergency department beds were available.
本研究的目的是确定在城市学术性急诊科实施床边登记是否会影响患者周转时间。这是一项前后对照的干预性研究。将2001年11月开始实施床边登记前的8个月与随后的三个4个月时间段进行比较。对一天中的四个时段和三种分诊类别进行了检查。数据采用三因素协方差分析进行分析。共分析了58225例患者就诊情况。床边登记开始后，从分诊到进入病房的时间有显著差异（p < 0.0001）。按分诊类别检查时，急诊患者分诊到病房的时间无差异，紧急患者最初有显著减少，非紧急患者也有显著减少。按一天中的时间来看，床边登记最初缩短了所有四个时段的时间，但一年后，除上午时段外，其他时段又回到了床边登记前的水平。床边登记最初减少了非紧急患者和紧急患者分诊到病房的时间，但在1年末这种效果未持续。对常规立即被送入患者护理区的急诊患者没有影响。床边登记的可持续效果出现在上午有急诊科床位可用的时候。
