Gerdtz Marie Frances, Kapp Suzanne, Michael Elaine, Prematunga Roshani, Virtue Elizabeth, Knott Jonathan
Royal Melbourne Hospital Emergency Department - Melbourne Health (study site), Australia; Department of Nursing, Melbourne School of Health Sciences, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Australia.
Department of Nursing, Melbourne School of Health Sciences, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Australia.
Australas Emerg Care. 2019 Dec;22(4):229-235. doi: 10.1016/j.auec.2019.08.001. Epub 2019 Sep 6.
To evaluate the use of management plans for people who frequently attend the emergency department (ED).
Management plans are used to decrease ED utilisation by people who frequently attend. There is limited evidence regarding the use management plans for this population and the perspectives of staff who use them has previously not been considered.
A descriptive observational design including before and after measures of attendance (November 2010 to September 2014) and survey of staff perceptions (July to November 2014). The setting was a major metropolitan hospital ED in Australia.
The date for commencement of each plan was determined. Data were extracted regarding ED attendance 12 months before and after implementation. Staff perspectives were obtained via an online survey.
Fifty-seven patients made 1482 ED attendances. Of these 830 occurred in the 12 months before the management plan was implemented and 652 during the 12 months after. The number of attendances per patient decreased from a median of 11 to 4. Staff considered management plans to be beneficial to care planning practices and individual patient outcomes.
Management plans were acceptable to staff, and implementation of management plans was associated with a decrease in ED attendance.
评估针对频繁前往急诊科（ED）的患者使用管理计划的情况。
管理计划用于减少频繁就诊患者的急诊科利用率。关于针对这一人群使用管理计划的证据有限，且此前未考虑过使用这些计划的工作人员的观点。
一种描述性观察性设计，包括就诊情况的前后测量（2010年11月至2014年9月）以及工作人员认知调查（2014年7月至11月）。研究地点为澳大利亚一家大型都市医院的急诊科。
确定每个计划开始的日期。提取实施管理计划前后12个月的急诊科就诊数据。通过在线调查获取工作人员的观点。
57名患者进行了1482次急诊科就诊。其中，830次发生在管理计划实施前的12个月，652次发生在实施后的12个月。每位患者的就诊次数中位数从11次降至4次。工作人员认为管理计划对护理规划实践和个体患者结局有益。
管理计划为工作人员所接受，且管理计划的实施与急诊科就诊次数的减少相关。
