Barnes Geoffrey, Giri Jay, Courtney D Mark, Naydenov Soophia, Wood Todd, Rosovsky Rachel, Rosenfield Kenneth, Kabrhel Christopher
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.
Hosp Pract (1995). 2017 Aug;45(3):76-80. doi: 10.1080/21548331.2017.1309954. Epub 2017 Mar 31.
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.
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.
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.
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.
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。
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。
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。
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。