Division of Hospital Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO UCHealth, Aurora, CO Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
Am J Med Qual. 2021;36(2):84-89. doi: 10.1097/01.JMQ.0000735436.50361.79.
The posthospital discharge period is vulnerable for patients with coronavirus disease 2019 (COVID-19). The authors implemented a COVID-19 discharge pathway in the electronic medical record for UCHealth, a 12-hospital health care system, including an academic medical center (University of Colorado Hospital [UCH]), to improve patient safety by standardizing discharge processes for COVID-19 patients. There were 3 key elements: (1) building consensus on discharge readiness criteria, (2) summarizing discharge criteria for disposition locations, and (3) establishing primary care follow-up protocols. The discharge pathway was opened 821 times between April 20, 2020, and June 7, 2020. Of the 436 patients discharged from the hospital medicine service at UCH from April 20, 2020, and June 7, 2020, 18 (4%) were readmitted and 13 (3%) had a 30-day emergency department visit. The main trend observed was venous thromboembolism. This pathway allowed real-time integration of clinical guidelines and complex disposition requirements, decreasing cognitive burden and standardizing care for a complex population.
新冠肺炎患者出院后仍然面临风险。作者在 UCHealth 的电子病历中实施了一种新冠肺炎出院流程，UCHealth 是一个拥有 12 家医院的医疗系统，包括一所学术医疗中心（科罗拉多大学医院[UCH]），旨在通过标准化新冠肺炎患者的出院流程来提高患者安全。该流程有 3 个关键要素：（1）就出院准备标准达成共识；（2）总结出院标准的处置地点；（3）建立初级保健随访方案。该出院流程自 2020 年 4 月 20 日至 6 月 7 日共开放了 821 次。在 2020 年 4 月 20 日至 6 月 7 日期间，从 UCH 医院内科出院的 436 名患者中，有 18 名（4%）再次入院，有 13 名（3%）在 30 天内到急诊就诊。观察到的主要趋势是静脉血栓栓塞。该流程允许实时整合临床指南和复杂的处置要求，减轻认知负担并为复杂人群标准化护理。
