Wathes Rowan, Clifford Amy, Januszewski Adam, Urch Catherine
Imperial College Healthcare NHS Trust, London, UK.
Royal Marsden NHS Foundation Trust, London, UK.
Future Hosp J. 2015 Oct;2(3):162-165. doi: 10.7861/futurehosp.2-3-162.
The oncology department at Imperial College Healthcare Trust ranked last in the National Cancer Patient Experience Survey in 2011/12 and 2012/13. Length of stay (LOS) was above national average. General Medical Council surveys of junior doctors highlighted significant issues with lack of senior review, education and working hours. Inpatient surveys echoed this with poor patient experience, and major complaints exposed lack of joint nursing and medical care. Restructuring the inpatient care pathway began in 2012 and centred around four target areas: 1) introduction of a ward based consultant; 2) defined admission criteria; 3) development of a cancer assessment unit; and 4) designated elective beds. Restructuring had a rapid effect on the service: total admissions per month declined from 246 in March 2013 to 183 in May 2014 and median LOS fell from 4.3 to 2 days over the same period (p<0.001). Complaints and serious incidents also fell and junior doctor satisfaction improved.
帝国理工学院医疗保健信托基金的肿瘤科在2011/12年度和2012/13年度的全国癌症患者体验调查中排名垫底。住院时间高于全国平均水平。英国医学总会对初级医生的调查突出了缺乏上级审查、教育和工作时间方面的重大问题。住院患者调查也反映出患者体验不佳，主要投诉暴露了联合护理和医疗服务的不足。2012年开始对住院护理路径进行重组，重点围绕四个目标领域：1）引入病房顾问；2）明确入院标准；3）建立癌症评估单元；4）指定选择性床位。重组对服务产生了迅速的影响：每月总入院人数从2013年3月的246人降至2014年5月的183人，同期住院时间中位数从4.3天降至2天（p<0.001）。投诉和严重事件也有所减少，初级医生的满意度有所提高。
