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跨专业碰头会:一家儿童医院改善患者流程的方法。

Interprofessional Huddle: One Children’s Hospital’s Approach to Improving Patient Flow.

作者信息

McBeth Cheryl L, Durbin-Johnson Blythe, Siegel Elena O

出版信息

Pediatr Nurs. 2017 Mar-Apr;43(2):71-76.

Abstract

Admitting pediatric patients promptly to the appropriate unit where they can receive specialty care is of critical importance to safe, quality care. A daily morning huddle was implemented at one children’s hospital as a quality improvement project. The aim of this project was to improve patient flow throughout the children’s hospital by improving interprofessional and interdepartmental communication and collaboration. This article reports on changes in patient flow before and after implementation of the daily huddle, as measured by pediatric emergency department (ED) boarding times. This retrospective, descriptive study was conducted at a regional children’s hospital within an academic hospital. Data were collected from the electronic medical record over two separate time periods coinciding with pre/post-huddle implementation. Non-random, purposive sampling was used, resulting in a prehuddle sample (n = 450) and post-huddle sample (n = 329). Times were significantly shorter after huddle implementation compared to pre-huddle (p < 0.001) from admission orders in the ED to transfer to the PICU or pediatric ward. The median time decreased from 3.0 to 2.6 hours post-huddle implementation. These findings suggest huddles as one potential factor in the formula to improve patient flow from the ED by enhancing interprofessional and interdepartmental collaboration and communication. Findings from this study are of vital importance to pediatric patients, nurses, and physicians. Promptly admitting patients from the ED to the appropriate unit where they can receive needed specialty care that potentially improves the quality and safety of patient care is paramount. Further research is needed to determine what format and contexts the huddle can be utilized to facilitate efficient patient flow and improve patient outcomes.

摘要

及时将儿科患者收治到能够提供专科护理的合适科室,对于安全、高质量的护理至关重要。一家儿童医院实施了每日晨会作为质量改进项目。该项目的目的是通过改善跨专业和跨部门的沟通与协作,优化儿童医院的患者流程。本文报告了每日晨会实施前后患者流程的变化,以儿科急诊科(ED)的留观时间来衡量。这项回顾性描述性研究在一家学术医院的地区儿童医院进行。在与晨会实施前/后相吻合的两个不同时间段,从电子病历中收集数据。采用非随机、目的抽样法,得到晨会前样本(n = 450)和晨会后样本(n = 329)。从急诊科下达入院医嘱到转至儿科重症监护病房(PICU)或儿科病房,晨会实施后的时间明显短于晨会前(p < 0.001)。晨会实施后,中位时间从3.0小时降至2.6小时。这些发现表明,晨会是通过加强跨专业和跨部门协作与沟通来改善急诊科患者流程的一个潜在因素。本研究结果对儿科患者、护士和医生至关重要。及时将急诊科患者收治到能够提供所需专科护理的合适科室,这可能提高患者护理的质量和安全性,至关重要。需要进一步研究以确定晨会可以采用何种形式以及在何种背景下能够促进高效的患者流程并改善患者结局。

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