以家庭为中心的查房：它会影响学术型儿童医院的出院时间和检查完成时间吗？

Family-centered rounding: can it impact the time of discharge and time of completion of studies at an academic children's hospital?

作者信息

Oshimura Jennifer M, Downs Stephen M, Saysana Michele

机构信息

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana

Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana.

出版信息

Hosp Pediatr. 2014 Jul;4(4):228-32. doi: 10.1542/hpeds.2013-0085.

DOI:10.1542/hpeds.2013-0085

PMID:24986992

Abstract

BACKGROUND AND OBJECTIVE

Family-centered rounds (FCR) involve multidisciplinary rounds at the patient bedside with an emphasis on physicians partnering with patients and families in the clinical decision-making for the patient. Although the purpose of FCR is to provide patient-centered care, an unanticipated benefit of FCR may be to improve time to discharge. The objective of this study was to determine the impact of FCR on time to discharge for pediatric patients in an academic medical center.

METHODS

We retrospectively compared the timing of patient discharges from July 2007 to June 2008 (before FCR) versus those from July 2008 to May 2009 (after FCR) on the pediatric hospital medicine service. We further compared time from order entry to study completion on a subset of patients receiving head MRIs and EEGs, studies that typically occurred on the day of discharge.

RESULTS

In our center, before FCR, 40% of patients were discharged before 3:00 pm (n = 912). After FCR, 47% of children were discharged before 3:00 pm (n = 911) (P = .0036). Time from order entry to study completion for MRIs and EEGs decreased from 2.15 hours before FCR (n = 225) to 1.73 hours after FCR (n = 206) (P = .001).

CONCLUSIONS

FCR provided a modest improvement in the timeliness of the discharge process at our institution.

摘要

背景与目的

以家庭为中心的查房（FCR）包括在患者床边进行多学科查房，重点是医生与患者及其家属合作参与患者的临床决策。尽管FCR的目的是提供以患者为中心的护理，但FCR的一个意外好处可能是缩短出院时间。本研究的目的是确定FCR对一家学术医疗中心儿科患者出院时间的影响。

方法

我们回顾性比较了2007年7月至2008年6月（FCR实施前）与2008年7月至2009年5月（FCR实施后）儿科医院内科服务患者的出院时间。我们还比较了接受头部MRI和脑电图检查的部分患者从医嘱录入到检查完成的时间，这些检查通常在出院当天进行。

结果

在我们中心，FCR实施前，40%的患者在下午3:00之前出院（n = 912）。FCR实施后，47%的儿童在下午3:00之前出院（n = 911）（P = .0036）。MRI和脑电图检查从医嘱录入到检查完成的时间从FCR实施前的2.15小时（n = 225）降至FCR实施后的1.73小时（n = 206）（P = .001）。