Hahn-Goldberg S, Chow E, Appel E, Ko F T F, Tan P, Gavin M B, Ng T, Abrams H B, Casaubon L K, Carter M W
Centre for Innovation in Complex Care, University Health Network, Toronto, Ontario, Canada.
Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario, Canada.
J Healthc Eng. 2014;5(3):347-59. doi: 10.1260/2040-2295.5.3.347.
Evidence exists that clinical outcomes improve for stroke patients admitted to specialized Stroke Units. The Toronto Western Hospital created a Neurovascular Unit (NVU) using beds from general internal medicine, Neurology and Neurosurgery to care for patients with stroke and acute neurovascular conditions. Using patient-level data for NVU-eligible patients, a discrete event simulation was created to study changes in patient flow and length of stay pre- and post-NVU implementation. Varying patient volumes and resources were tested to determine the ideal number of beds under various conditions. In the first year of operation, the NVU admitted 507 patients, over 66% of NVU-eligible patient volumes. With the introduction of the NVU, length of stay decreased by around 8%. Scenario testing showed that the current level of 20 beds is sufficient for accommodating the current demand and would continue to be sufficient with an increase in demand of up to 20%.
有证据表明，入住专业卒中单元的卒中患者临床结局有所改善。多伦多西部医院利用普通内科、神经内科和神经外科的床位设立了一个神经血管单元（NVU），以护理卒中及急性神经血管疾病患者。利用符合NVU收治标准患者的个体层面数据，创建了一个离散事件模拟模型，以研究NVU实施前后患者流程和住院时间的变化。对不同的患者数量和资源进行了测试，以确定各种条件下的理想床位数。在运营的第一年，NVU收治了507名患者，超过符合NVU收治标准患者数量的66%。随着NVU的引入，住院时间缩短了约8%。情景测试表明，目前的20张床位足以满足当前需求，并且在需求增加高达20%的情况下仍将足够。
