Lees-Deutsch Liz, Jackson Julia, Balaji Ariyur, Topping Annie
Department of Acute Medicine, Heartlands Hospital (Drs Lees-Deutsch and Balaji and Ms Jackson) and Queen Elizabeth Hospital (Prof Topping), University Hospitals Birmingham Foundation NHS Trust, Birmingham, England; and Nursing School, Institute of Clinical Sciences, University of Birmingham, Birmingham, England (Dr Lees-Deutsch and Prof Topping).
J Nurs Care Qual. 2020 Apr/Jun;35(2):140-146. doi: 10.1097/NCQ.0000000000000423.
Criteria-led discharge (CLD) is an approach for maximizing bed capacity by expediting patient discharge.
In acute medicine settings, patients commonly have multiple medical problems, which render single care pathway and clinical protocols of limited use. CLD offers potential, but little evidence exists about how to best implement it in these contexts.
Retrospective case note analysis generated characteristics from patients' discharge plans to design a criterion-based framework to aid patient selection for CLD. These criteria were hypothetically tested on patient case notes (n = 50).
CLD was identified as suitable (n = 27) and unsuitable (n = 23) from 50 case notes. Interrater agreement was 86% between 3 reviewers.
This review has provided greater understanding of the complexity of discharge in acute medicine settings. Implementing CLD to optimize timeliness of patient discharge might offer a solution for selected patients.
标准引导出院（CLD）是一种通过加快患者出院来最大化床位容量的方法。
在急性医学环境中，患者通常存在多种医疗问题，这使得单一的护理路径和临床方案的作用有限。CLD具有潜力，但在这些情况下如何最佳实施它的证据很少。
回顾性病例记录分析从患者出院计划中生成特征，以设计一个基于标准的框架，帮助选择适合CLD的患者。这些标准在50份患者病例记录上进行了假设检验。
从50份病例记录中确定CLD适合（n = 27）和不适合（n = 23）。3名评审员之间的评分者间一致性为86%。
本综述对急性医学环境中出院的复杂性有了更深入的了解。实施CLD以优化患者出院的及时性可能为选定的患者提供解决方案。
