Meislin H W, Coates S A, Cyr J, Valenzuela T
Department of Surgery, Arizona Health Sciences Center, Tucson 85724.
Ann Emerg Med. 1988 May;17(5):453-6. doi: 10.1016/s0196-0644(88)80235-x.
We performed a ten-week study to understand the feasibility of a fast track system within a teaching hospital setting. Our results show that 50% or fewer of patients entering an emergency department during evening and weekend day hours can be seen in Fast Track. Average turnaround time for all patients in the ED was 161 minutes. The average for all Fast Track patients was 94.5 minutes; if laboratory and/or radiographs were ordered the average was 121.5 minutes; with no laboratory/radiographs, 79.1 minutes. Urinalysis, strep screen, and complete blood count accounted for 80% of all laboratory work. Roentgenograms of the ankle, foot, and knee accounted for 80% of all radiographs. An evaluation questionnaire showed enhanced satisfaction with a reduction in the number of complaints from 79% to 22%. The Fast Track system failed when there was a predominance of acutely ill patients in the ED, as house officers were pulled to care for the acutely ill patients.
我们进行了一项为期十周的研究，以了解教学医院环境中快速通道系统的可行性。我们的结果表明，在夜间和周末白天时段进入急诊科的患者中，只有50%或更少的患者能在快速通道就诊。急诊科所有患者的平均周转时间为161分钟。快速通道所有患者的平均周转时间为94.5分钟；如果进行了实验室检查和/或X光检查，平均周转时间为121.5分钟；未进行实验室检查/X光检查时，平均周转时间为79.1分钟。尿液分析、链球菌筛查和全血细胞计数占所有实验室检查的80%。脚踝、足部和膝盖的X光片占所有X光检查的80%。一份评估问卷显示，患者满意度提高，投诉数量从79%降至22%。当急诊科中急重症患者占主导时，快速通道系统就会失效，因为住院医生会被抽调去照顾急重症患者。
