利用学术医疗中心电子护理交接班流程提高患者吞吐量：快速改善事件方法。
Improving Patient Throughput With an Electronic Nursing Handoff Process in an Academic Medical Center: A Rapid Improvement Event Approach.
机构信息
Author Affiliations: Manager of Specialty Nursing in the Professional Nursing Practice (Dr Sermersheim), Project Lead of Clinical Applications in the Clinical Information Systems (Mr Moon), Unit Director (Dr Streelman), Assistant Unit Director of Post Anesthesia Care Unit (Ms McCullum-Smith), Registered Nurse in the Emergency Department (Ms Fromm), Unit Director of Neurosurgical Intensive Care Unit (Dr Yohannan), and Bed Management RN in the Patient Placement Department (Ms Powell), Rush University Medical Center, Chicago, Illinois.
出版信息
J Nurs Adm. 2020 Mar;50(3):174-181. doi: 10.1097/NNA.0000000000000862.
OBJECTIVE
Rush University Medical Center nursing leadership undertook a process improvement project to revamp nursing handoff during unit transfer with the goal of improving patient throughput. The aim was to decrease assign-to-occupy time, the duration from bed assignment to bed occupancy.
BACKGROUND
There was a lengthy lag time in admitting/transferring patients, leading to delays in patient throughput and potential threats to patient safety. In fiscal year 2016, assign-to-occupy time averaged 97 minutes. The goal was to decrease that time to 60 minutes or less.
METHODS
Process improvement leaders held a rapid improvement event to determine viable solutions. A team then standardized handoff workflow; created an electronic tool, virtually eliminating verbal report; and implemented a new handoff process.
RESULTS
Assign-to-occupy time at 1 year after go-live averaged 55 minutes, and it has been staying less than 60 minutes since the implementation.
CONCLUSIONS
Key success strategies included engaging stakeholders during the rapid improvement event, imploring frontline nurses to create and promote the revised process to facilitate staff engagement, and leveraging electronic health records.
目的
拉什大学医学中心护理领导层开展了一个流程改进项目，对单元转科期间的护理交接班进行了改进，旨在提高患者的吞吐量。目标是减少分配到占用时间，即从床位分配到床位占用的时间。
背景
患者入院/转科的时间很长，导致患者吞吐量延迟，并对患者安全构成潜在威胁。在 2016 财年，分配到占用时间平均为 97 分钟。目标是将这一时间减少到 60 分钟或更短。
方法
流程改进领导者举行了一次快速改进活动，以确定可行的解决方案。然后，一个团队对交接班工作流程进行了标准化；创建了一个电子工具，基本上消除了口头报告；并实施了新的交接班流程。
结果
实施后 1 年的分配到占用时间平均为 55 分钟，此后一直保持在 60 分钟以下。
结论
关键的成功策略包括在快速改进活动中让利益相关者参与，恳请一线护士创建和推广修订后的流程，以促进员工参与，并利用电子病历。
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