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组建肺栓塞应对团队的要点:来自国家肺栓塞反应团队(PERT™)联盟成员组织调查的结果

Nuts and bolts of running a pulmonary embolism response team: results from an organizational survey of the National PERT™ Consortium members.

作者信息

Barnes Geoffrey, Giri Jay, Courtney D Mark, Naydenov Soophia, Wood Todd, Rosovsky Rachel, Rosenfield Kenneth, Kabrhel Christopher

机构信息

a Frankel Cardiovascular Center and Institute for Healthcare Policy and Innovation, Department of Internal Medicine , University of Michigan Medical School , Ann Arbor , MI , USA.

b Penn Cardiovascular Outcomes, Quality and Evaluative Research Center , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.

出版信息

Hosp Pract (1995). 2017 Aug;45(3):76-80. doi: 10.1080/21548331.2017.1309954. Epub 2017 Mar 31.

Abstract

OBJECTIVES

Pulmonary embolism response teams (PERT) are developing rapidly to operationalize multi-disciplinary care for acute pulmonary embolism patients. Our objective is to describe the core components of PERT necessary for newly developing programs.

METHODS

An online organizational survey of active National PERT™ Consortium members was performed between April and June 2016. Analysis, including descriptive statistics and Kruskal-Wallis tests, was performed on centers self-reporting a fully operational PERT program.

RESULTS

The survey response rate was 80%. Of the 31 institutions that responded (71% academic), 19 had fully functioning PERT programs. These programs were run by steering committees (17/19, 89%) more often than individual physicians (2/19, 11%). Most PERT programs involved 3-5 different specialties (14/19, 74%), which did not vary based on hospital size or academic affiliation. Of programs using multidisciplinary discussions, these occurred via phone or conference call (12/18, 67%), with a minority of these utilizing 'virtual meeting' software (2/12, 17%). Guidelines for appropriate activations were provided at 16/19 (84%) hospitals. Most PERT programs offered around-the-clock catheter-based or surgical care (17/19, 89%). Outpatient follow up usually occurred in personal physician clinics (15/19, 79%) or dedicated PERT clinics (9/19, 47%), which were only available at academic institutions.

CONCLUSIONS

PERT programs can be implemented, with similar structures, at small and large, community and academic medical centers. While all PERT programs incorporate team-based multi-disciplinary care into their core structure, several different models exist with varying personnel and resource utilization. Understanding how different PERT programs impact clinical care remains to be investigated.

摘要

目的

肺栓塞反应小组(PERT)正在迅速发展,以便为急性肺栓塞患者实施多学科护理。我们的目的是描述新开发项目所需的PERT核心组成部分。

方法

2016年4月至6月对国家PERT™联盟的活跃成员进行了在线组织调查。对自我报告有全面运行的PERT项目的中心进行了分析,包括描述性统计和Kruskal-Wallis检验。

结果

调查回复率为80%。在回复的31家机构中(71%为学术机构),19家拥有全面运作的PERT项目。这些项目大多由指导委员会运作(17/19,89%),而非由个别医生运作(2/19,11%)。大多数PERT项目涉及3 - 5个不同专业(14/19,74%),且不因医院规模或学术隶属关系而有所不同。在采用多学科讨论的项目中,这些讨论通过电话或电话会议进行(12/18,67%),其中少数使用“虚拟会议”软件(2/12,17%)。16/19(84%)的医院提供了适当激活的指南。大多数PERT项目提供全天候的导管介入或手术治疗(17/19,89%)。门诊随访通常在私人医生诊所(15/19,79%)或专门的PERT诊所(9/19,47%)进行,后者仅在学术机构才有。

结论

无论大小、社区及学术医疗中心,均可采用类似结构实施PERT项目。虽然所有PERT项目都将基于团队的多学科护理纳入其核心结构,但存在几种不同模式,人员和资源利用情况各异。不同PERT项目如何影响临床护理仍有待研究。

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