Department of Obstetrics and Gynecology, Dongguk University College of Medicine, Goyang, 10326, Republic of Korea.
Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
Taiwan J Obstet Gynecol. 2021 Sep;60(5):851-856. doi: 10.1016/j.tjog.2021.07.012.
This study aimed to identify the impact of care and change in the consultation process given by a gynecologic hospitalist on patient waiting time in the emergency department (ED).
This is a pre-post study that compared patients' length of stay at the ED ten months before and after intervention by the gynecologic hospitalist in 2018. The consultation process changed from ED staff contacting the gynecologic resident (pre-intervention group) to directly contacting the gynecologic hospitalist (post-intervention group). Times elapsed from gynecologic consultation to final disposition, from gynecologic consultation to discharge, and from arrival at ED to discharge were compared between the two groups.
Among 945 referrals at the ED during the study period, the number of daytime weekday gynecologic consultations were 68 and 187 cases in the pre-intervention and post-intervention groups, respectively. The time elapsed from gynecologic consultation to the final disposition, the time elapsed from gynecologic consultation to discharge and the time elapsed from arrival at ED to discharge were shorter in the post-intervention group than in the pre-intervention group (median values, 98 vs. 167.5 min, 205 vs. 311.5 min, and 419 vs. 497 min; P < 0.05), and extended length of stay more than 12 h at the ED was less common in the post-intervention group than in the pre-intervention group (9.6 vs. 19.1%; P < 0.01).
The waiting time of gynecologic patients upon admission and prolonged length of stay at ED significantly decreased after the establishment of the gynecologic hospitalist system.
本研究旨在确定妇科医院医生在咨询过程中的护理和改变对急诊科（ED）患者等待时间的影响。
这是一项前后对照研究，比较了 2018 年妇科医院医生干预前后十个月在 ED 的患者停留时间。咨询过程从 ED 工作人员联系妇科住院医师（干预前组）改为直接联系妇科医院医生（干预后组）。比较了两组之间从妇科咨询到最终处置、从妇科咨询到出院以及从到达 ED 到出院的时间。
在研究期间的 945 例 ED 转诊中，白天工作日妇科咨询的数量在干预前组和干预后组分别为 68 例和 187 例。从妇科咨询到最终处置、从妇科咨询到出院以及从到达 ED 到出院的时间在干预后组比干预前组更短（中位数，98 与 167.5 分钟，205 与 311.5 分钟，419 与 497 分钟；P<0.05），在 ED 延长超过 12 小时的停留时间在干预后组比干预前组更少见（9.6 与 19.1%；P<0.01）。
建立妇科医院医生制度后，妇科患者入院等待时间和 ED 延长停留时间显著缩短。
