Jarvis Paul Richard Edwin
Emergency Department, Calderdale & Huddersfield NHS Foundation Trust, West Yorkshire, UK.
Clin Exp Emerg Med. 2016 Jun 30;3(2):63-68. doi: 10.15441/ceem.16.127. eCollection 2016 Jun.
Emergency departments (ED) face significant challenges in delivering high quality and timely patient care on an ever-present background of increasing patient numbers and limited hospital resources. A mismatch between patient demand and the ED's capacity to deliver care often leads to poor patient flow and departmental crowding. These are associated with reduction in the quality of the care delivered and poor patient outcomes. A literature review was performed to identify evidence-based strategies to reduce the amount of time patients spend in the ED in order to improve patient flow and reduce crowding in the ED. The use of doctor triage, rapid assessment, streaming and the co-location of a primary care clinician in the ED have all been shown to improve patient flow. In addition, when used effectively point of care testing has been shown to reduce patient time in the ED. Patient flow and departmental crowding can be improved by implementing new patterns of working and introducing new technologies such as point of care testing in the ED.
在患者数量不断增加而医院资源有限这一长期存在的背景下,急诊科在提供高质量、及时的患者护理方面面临重大挑战。患者需求与急诊科提供护理的能力之间的不匹配往往导致患者流程不畅和科室拥挤。这些与所提供护理质量的下降以及患者不良预后相关。进行了一项文献综述,以确定基于证据的策略,以减少患者在急诊科的停留时间,从而改善患者流程并减少急诊科的拥挤情况。使用医生分诊、快速评估、分流以及在急诊科配备初级保健临床医生均已证明可改善患者流程。此外,有效使用即时检验已证明可减少患者在急诊科的停留时间。通过实施新的工作模式并引入新技术,如急诊科的即时检验,可改善患者流程和科室拥挤情况。