Johns Hopkins Hospital, Baltimore, Maryland.
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.
J Patient Saf. 2020 Dec;16(4):e250-e254. doi: 10.1097/PTS.0000000000000376.
A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit.
A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital.
Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program.
The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.
一项名为“应对压力事件中的韧性（RISE）”的同伴支持计划旨在帮助医院工作人员应对与患者相关的压力事件。本研究旨在通过对其成本效益进行经济评估来评估 RISE 计划的影响。
采用 1 年时间范围的 Markov 模型，从提供者（医院）的角度比较了实施 RISE 计划前后的成本效益。该分析纳入了美国一家拥有 1000 张床位的私立医院在 2015 年至 2016 年期间使用 RISE 计划的护理人员。对 RISE 计划的运行成本、护士离职率和护士休假时间进行了建模。成本数据来自文献综述和医院数据。使用调查数据估计了在有无 RISE 计划的情况下离职或休假的概率。计算净货币效益（NMB）和实施 RISE 计划的预算影响，以确定对医院的成本效益。
预期的 RISE 计划模型结果发现，每启动一次 RISE 电话的护士可节省 22576.05 美元的净货币效益。基于概率敏感性分析，这些节省被确定为 99.9%一致。预算影响分析表明，由于 RISE 计划，医院每年可节省 181 万美元。
RISE 计划为医院节省了大量成本。这些发现应鼓励医院根据对这种服务的高需求和节省成本的潜力，为医护人员实施全机构支持计划。
