改善入院流程和住院时间的策略：对适当性评估协议（AEP）改编版的德尔菲研究。

Strategies to improve the flow of admissions and hospital stays: a Delphi study of an adaptation of the Appropriateness Evaluation Protocol (AEP).

作者信息

Morillo-Rodríguez A, Alonso-Fernández S, Mòdol Deltell J M, Soldevila Madorell B, Benito-Aracil Ll, Parés D

机构信息

Instituto de Investigación en Ciencias de la Salud Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain.

Instituto de Investigación en Ciencias de la Salud Germans Trias i Pujol, Badalona, Barcelona, Spain; Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, Spain; Departamento de Enfermería Fundamental y Médico-Quirúrgica, Facultad de Medicina y Ciencias de la Salud, Escuela de Enfermería, Universitat de Barcelona (UB), L'Hospitalet de Llobregat, Barcelona, Spain.

出版信息

Rev Clin Esp (Barc). 2023 May;223(5):270-280. doi: 10.1016/j.rceng.2023.04.003. Epub 2023 Apr 12.

DOI:10.1016/j.rceng.2023.04.003

PMID:37059299

Abstract

INTRODUCTION AND AIM

The Appropriateness Evaluation Protocol (AEP) tool analyzes inappropriate hospital stays and admissions. This study aimed to adapt the AEP questionnaire in order to analyse the appropriateness of hospital admissions and stays in our healthcare reality.

METHODS

A study was conducted using the Delphi method in which 15 experts in clinical management and hospital care participated. The initial questionnaire items were taken from the first version of the AEP. In the first round, the participants contributed new items that they considered relevant in our current reality. In rounds 2 and 3, they evaluated 80 items according to their relevance using a Likert scale from 1 to 4 (maximum usefulness). Pursuant to the study's design, AEP items were considered adequate if the mean score according to the experts' evaluation was greater than or equal to 3.

RESULTS

The participants defined a total of 19 new items. In the end, 47 items earned a mean score greater than or equal to 3. The resulting modified questionnaire include 17 items in "Reasons for Appropriate Admissions," 5 in "Reasons for Inappropriate Admissions," 15 in "Reasons for Appropriate Hospital Stays," and 10 in "Reasons for Inappropriate Hospital Stays."

CONCLUSIONS

The identification according to expert opinion of priority items to determine the appropriateness of admissions and extended stays could be used in the future to help create an instrument to be used in our setting.

摘要

引言与目的

适宜性评估方案（AEP）工具可分析不适当的住院和入院情况。本研究旨在对AEP问卷进行调整，以便在我们的医疗环境中分析入院和住院的适宜性。

方法

采用德尔菲法进行研究，15名临床管理和医院护理专家参与其中。初始问卷项目取自AEP的第一版。在第一轮中，参与者提出了他们认为在我们当前环境中相关的新项目。在第二轮和第三轮中，他们使用1至4分的李克特量表（最高效用）根据相关性对80个项目进行评估。根据研究设计，如果专家评估的平均得分大于或等于3，则认为AEP项目是合适的。