Sayah Assaad, Rogers Loni, Devarajan Karthik, Kingsley-Rocker Lisa, Lobon Luis F
Department of Emergency Medicine, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA.
Tufts University School of Medicine, Boston, MA, USA ; Heller School of Social Policy and Management, Brandeis University, Waltham, MA, USA.
Emerg Med Int. 2014;2014:981472. doi: 10.1155/2014/981472. Epub 2014 Apr 14.
We conducted a pre- and postintervention analysis to assess the impact of a process improvement project at the Cambridge Hospital ED. Through a comprehensive and collaborative process, we reengineered the emergency patient experience from arrival to departure. The ED operational changes have had a significant positive impact on all measured metrics. Ambulance diversion decreased from a mean of 148 hours per quarter before changes in July 2006 to 0 hours since April 2007. ED total length of stay decreased from a mean of 204 minutes before the changes to 132 minutes. Press Ganey patient satisfaction scores rose from the 12th percentile to the 59th percentile. ED patient volume grew by 11%, from a mean of 7,221 patients per quarter to 8,044 patients per quarter. Compliance with ED specific quality core measures improved from a mean of 71% to 97%. The mean rate of ED patients that left without being seen (LWBS) dropped from 4.1% to 0.9%. Improving ED operational efficiency allowed us to accommodate increasing volume while improving the quality of care and satisfaction of the ED patients with minimal additional resources, space, or staffing.
我们进行了干预前后分析，以评估剑桥医院急诊科流程改进项目的影响。通过全面协作的过程，我们对急诊患者从入院到出院的体验进行了重新设计。急诊科的运营变化对所有测量指标都产生了显著的积极影响。救护车分流从2006年7月变化前每季度平均148小时降至2007年4月以来的0小时。急诊科总住院时间从变化前的平均204分钟降至132分钟。Press Ganey患者满意度评分从第12百分位升至第59百分位。急诊科患者数量增长了11%，从每季度平均7221例增至每季度8044例。急诊科特定质量核心指标的合规率从平均71%提高到97%。急诊科未就诊即离开（LWBS）的患者平均比例从4.1%降至0.9%。提高急诊科运营效率使我们能够在增加工作量的同时，以最少的额外资源、空间或人员配置提高护理质量和急诊科患者的满意度。
