Cunningham Megan E, Justus Caitlin A, Milewicz Allen L, Wortley Martin G, Denner Felicia R, Hollier Larry H, Nuchtern Jed G, Wesson David E, Fraser Charles D, Shah Sohail R
Texas Children's Hospital, Department of Surgery, Houston, TX.
Texas Children's Hospital, Department of Surgery, Houston, TX.
J Pediatr Surg. 2019 Jun;54(6):1108-1111. doi: 10.1016/j.jpedsurg.2019.02.047. Epub 2019 Mar 1.
BACKGROUND/PURPOSE: Elective ambulatory surgical care traditionally involves three independent visits. Single-Visit Surgery (SVS) is an alternative surgical model that consolidates care into one visit. Evaluation of the effect of this novel program on hospital operations is limited. The objective of this study was to analyze SVS from an institutional perspective.
We retrospectively reviewed patients scheduled for SVS at a freestanding children's hospital between January 2016 and August 2017. Data collected included clinic "no show" rates, operating room (OR) utilization, reimbursement rates, and postoperative visits.
There were 89 patients scheduled for SVS, of which 63% (n=56) were male, and the median age was 6 years [IQR, 4-9]. The SVS clinic "no show" rate was 2% (n=2) compared to the pediatric surgery clinic "no show" rate of 11% (p=0.01). The SVS OR block utilization rate was 90%. Payment was received from third-party payors for 92% of consultations and 100% of operative procedures without securing prior authorization. Postoperatively 25% (n=17) of patients presented to clinic for follow-up, and one child presented to the emergency department for vomiting. There were no hospital admissions.
Single-Visit Surgery is an alternative model of ambulatory surgical care that improves institutional efficiency while also enhancing the patient experience.
Retrospective cohort review LEVEL OF EVIDENCE: III.
背景/目的:传统的择期门诊手术护理通常包括三次独立就诊。单次就诊手术(SVS)是一种替代手术模式,可将护理整合为一次就诊。对这一新型项目对医院运营效果的评估有限。本研究的目的是从机构角度分析单次就诊手术。
我们回顾性分析了2016年1月至2017年8月在一家独立儿童医院计划接受单次就诊手术的患者。收集的数据包括门诊“未就诊”率、手术室(OR)利用率、报销率和术后就诊情况。
有89例患者计划接受单次就诊手术,其中63%(n = 56)为男性,中位年龄为6岁[四分位间距,4 - 9岁]。单次就诊手术门诊“未就诊”率为2%(n = 2),而小儿外科门诊“未就诊”率为11%(p = 0.01)。单次就诊手术的手术室时间段利用率为90%。92%的会诊和100%的手术程序在未获得事先授权的情况下从第三方付款人处获得了付款。术后25%(n = 17)的患者到门诊进行随访,1名儿童因呕吐到急诊科就诊。无住院病例。
单次就诊手术是门诊手术护理可替代的模式,可提高机构效率,同时提升患者体验。
回顾性队列研究 证据级别:III级