Vestri Alec, Pizzighello Silvia, Piccoli Sara, Martinuzzi Andrea
Recovery and Care Scientific Institute (IRCCS) "E. Medea", Unit for the Rehabilitation of Acquired Neuropsychological Disorders, Pieve di Soligo and Conegliano (TV), Italy.
Recovery and Care Scientific Institute (IRCCS) "E. Medea", Unit for the Rehabilitation of Acquired Neuropsychological Disorders, Pieve di Soligo and Conegliano (TV), Italy.
Arch Phys Med Rehabil. 2017 Apr;98(4):746-750. doi: 10.1016/j.apmr.2016.11.018. Epub 2016 Dec 18.
To determine whether the use of a designated staff person to coordinate and schedule therapy services in a postacute residential rehabilitation program for people with acquired brain lesions results in (1) a higher-intensity treatment and a reduced length of stay; (2) reduced rehabilitation costs; and (3) increased patient and staff satisfaction.
This nonrandomized retrospective study from 2009 through 2012 uses data collected relative to 2 different methods of scheduling: (1) self-planning, in which each single team member makes appointments that are then displayed on a shared board; and (2) managed planning, in which appointments are made by a designated staff person.
A residential center for people with postacute acquired brain lesions.
Patients (N=20) with acquired brain lesions who had similar clinical and demographic characteristics comprised the managed planning group (n=10) and the self-planning group (n=10).
Not applicable.
Organizational measures (length of stay in rehabilitation, number of treatment hours, total cost of rehabilitation), clinical outcome scales (Disability Rating Scale, FIM, and Barthel Index), perceived quality of treatment by patients (questionnaire), and perceived satisfaction of team members (Job Descriptive Index).
All patients improved on all clinical rating scales at the time of discharge (all effect sizes are large). In the managed planning group, the number of treatment hours increased (Cohen's d=2.15), resulting in reduced length of stay (Cohen's d=.95) and cost of rehabilitation (Cohen's d=1.22). In addition, the quality of treatment perceived by the patients and their families increased, while team member satisfaction did not change.
The use of a designated staff person to manage therapy services improves efficiency and efficacy of a patient-centered health care system. The proposed scheduling system results in a remarkable cost saving for the National Health System.
确定在针对后天性脑损伤患者的急性后期住院康复项目中，使用指定工作人员来协调和安排治疗服务是否会带来以下结果：（1）更高强度的治疗和缩短住院时间；（2）降低康复成本；（3）提高患者和工作人员的满意度。
这项从2009年至2012年的非随机回顾性研究使用了相对于两种不同安排方法收集的数据：（1）自我规划，即每个团队成员单独预约，然后在共享板上显示；（2）管理规划，即由指定工作人员进行预约。
一个针对急性后期后天性脑损伤患者的住宿中心。
20名具有相似临床和人口统计学特征的后天性脑损伤患者组成了管理规划组（n = 10）和自我规划组（n = 10）。
不适用。
组织指标（康复住院时间、治疗小时数、康复总成本）、临床结局量表（残疾评定量表、功能独立性测量和巴氏指数）、患者感知的治疗质量（问卷）以及团队成员的感知满意度（工作描述指数）。
所有患者出院时在所有临床评定量表上均有改善（所有效应量均较大）。在管理规划组中，治疗小时数增加（科恩d值 = 2.15），导致住院时间缩短（科恩d值 = 0.95）和康复成本降低（科恩d值 = 1.22）。此外，患者及其家属感知的治疗质量提高，而团队成员的满意度未改变。
使用指定工作人员管理治疗服务可提高以患者为中心的医疗保健系统的效率和效果。所提议的安排系统为国家卫生系统带来了显著的成本节约。
