Kibler Judith, Lee Maria
Kaiser Permanente-Orange County, USA.
J Healthc Qual. 2011 Jan-Feb;33(1):68-76. doi: 10.1111/j.1945-1474.2010.00101.x.
This paper describes the work of a front-line team at a 200-bed hospital in southern California to improve the patient transfer process between the Intensive Care Unit (ICU) and the Medical/Surgical floors. Using a phased approach of assessing the problem, identifying opportunities, testing ideas, and then implementing successful ideas, the team was able to improve patient transfer time from the ICU to the Medical/Surgical Floor once the bed is assigned from 6 to < 2 hr and to reduce the number of patients experiencing extreme delays (more than 12 hr waits since the bed is assigned) from 15% to 0%. Also, as a corollary of this work, nursing overtime was reduced by 25% year to year between March 2008 and March 2009 and patient satisfaction scores were improved. A key success factor of the front-line team was the implementation of a sustainability plan where metric and process accountability is specified, together with alert flags for the metrics and actions to take if the alert flags are triggered.
本文介绍了南加州一家拥有200张床位的医院的一线团队为改善重症监护病房（ICU）与内科/外科楼层之间的患者转运流程所做的工作。该团队采用分阶段方法，即评估问题、确定机会、测试想法，然后实施成功的想法，一旦床位分配好，就能将患者从ICU转运至内科/外科楼层的时间从6小时缩短至不到2小时，并将经历极端延迟（自床位分配后等待超过12小时）的患者数量从15%降至0%。此外，作为这项工作的一个必然结果，2008年3月至2009年3月期间，护理加班时间逐年减少了25%，患者满意度得分也有所提高。一线团队的一个关键成功因素是实施了一项可持续性计划，其中明确了指标和流程问责制，以及指标的警示标志和触发警示标志时应采取的行动。
