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分诊区配备医生对患者未就诊即离院率的影响:法赫德国王专科医院的一项质量改进举措。

The effect of having a physician in the triage area on the rate of patients leaving without being seen: A quality improvement initiative at King Fahad Specialist hospital.

机构信息

From the Department of Emergency (Mahmood, AlQithmi), King Fahad Specialist Hospital, Dammam, from the Department of Emergency (AlGhamdi), Johns Hopkins Aramco Healthcare, Dhahran, from the Department of Emergency (Faris), Armed Forces Hospital, Jazan, Kingdom of Saudi Arabia, from the Department of Internal Medicine (Nasir), King Edward Medical University, Lahore, and from the Department of Internal Medicine (Salman), Dow University of Health Sciences, Karachi, Pakistan.

出版信息

Saudi Med J. 2024 Jan;45(1):74-78. doi: 10.15537/smj.2024.45.1.20230674.

Abstract

OBJECTIVES

To evaluate the effect of the presence of a physician in the triage area on the number of patients who leave without being seen (LWBS) and some of the factors affecting emergency department (ED) crowding.

METHODS

This was a pre-post study carried out at King Fahad Specialist Hospital, Dammam, Saudi Arabia. The 3-month study, consisting of 7826 patients, was split into pre-physician and post-physician periods. Variables compared across these periods were the number of LWBS patients, length of hospital stay, time to physician, and time to disposition decision. Statistical analysis was carried out using R version 4.3.0.

RESULTS

Our results showed that the presence of a triage physician significantly decreased the number of LWBS patients (<0.001) and the time taken to encounter an ED physician (<0.001). However, it did not have any significant impact on the length of hospital stay (=0.5) or time to disposition decision (=0.9).

CONCLUSION

The appointment of a triage physician has streamlined patient flow and decreased LWBS rates in the ED, demonstrating the need for more thorough research in this area.

摘要

目的

评估分诊区是否有医生在场对未就诊离开(LWBS)患者数量以及影响急诊部(ED)拥堵的一些因素的影响。

方法

这是在沙特阿拉伯达曼的法赫德国王专科医院进行的一项前后研究。这项为期 3 个月的研究包括 7826 名患者,分为有医生和无医生两个阶段。在这些阶段比较的变量包括 LWBS 患者数量、住院时间、看医生的时间和决定处置的时间。使用 R 版本 4.3.0 进行统计分析。

结果

我们的结果表明,分诊医生的存在显著减少了 LWBS 患者的数量(<0.001)和看 ED 医生的时间(<0.001)。然而,它对住院时间(=0.5)或决定处置的时间(=0.9)没有任何显著影响。

结论

分诊医生的任命使 ED 患者的流程更加顺畅,减少了 LWBS 率,这表明需要在这方面进行更深入的研究。

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