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缩短学生运营的免费诊所中儿科和成人患者的住院时间:一项质量改进计划。

Reducing Length of Stay for Pediatric and Adult Patients in a Student-Run Free Clinic: A Quality Improvement Initiative.

作者信息

Milanovic Silvija, Sartawi Tala, Shroff Sajan, Gahagan Kelly, Reid Miranda J, Rains Hannah, Lossius Michele N, Holland Carolyn K

机构信息

College of Medicine, University of Florida College of Medicine, Gainesville, USA.

Health Outcome and Biomedical Informatics, University of Florida College of Medicine, Gainesville, USA.

出版信息

Cureus. 2025 Aug 15;17(8):e90146. doi: 10.7759/cureus.90146. eCollection 2025 Aug.

Abstract

INTRODUCTION

Bartley Temple (BT), a church-based clinic within the University of Florida's Equal Access Clinic Network, provides care to a predominantly pediatric population as well as adult patients who are uninsured or underinsured. Long patient wait times are known to negatively impact patient satisfaction and clinic efficiency. This study aimed to reduce the median length of stay (LOS) at BT by 25%, from a baseline of 108.8 minutes to 81.6 minutes, through three Plan-Do-Study-Act (PDSA) cycles over six months.

METHODS

Three four-week PDSA cycles were implemented following baseline data collection for 12 weeks. PDSA 1 restructured officer roles to improve coordination. PDSA 2 introduced a patient tracker and checklist for the check-in volunteers. PDSA 3 optimized volunteer workflow and check-out processes. LOS data was collected using an Excel-based tracking system (Microsoft® Corp., Redmond, WA, USA). Statistical analysis was performed in R version 4.2.2 (The R Foundation for Statistical Computing, Vienna, Austria).

RESULTS

Although the initial goal of decreasing LOS by 25% was not met, the interventions collectively led to a reduction in median LOS, from 108.8 to 94.3 minutes (13.3%). Individually, pediatric patient LOS decreased by 10.2%, while adult patient LOS decreased by 25.0%.

CONCLUSION

Creating structured officer roles, patient trackers, checklists, and streamlined check-out processes successfully reduces LOS at a student-run clinic for both pediatric and adult patients.

摘要

引言

巴特利·坦普尔诊所(BT)是佛罗里达大学平等医疗诊所网络中一家以教会为基础的诊所,主要为儿科患者以及未参保或参保不足的成年患者提供医疗服务。众所周知,患者长时间等待会对患者满意度和诊所效率产生负面影响。本研究旨在通过在六个月内进行三个计划-实施-研究-改进(PDSA)循环,将BT诊所的中位住院时间(LOS)从基线的108.8分钟减少25%,降至81.6分钟。

方法

在收集了12周的基线数据后,实施了三个为期四周的PDSA循环。PDSA 1重新调整了工作人员角色以改善协调。PDSA 2为登记志愿者引入了患者追踪器和检查表。PDSA 3优化了志愿者工作流程和出院流程。使用基于Excel的追踪系统(美国华盛顿州雷德蒙德市微软公司)收集LOS数据。在R 4.2.2版本(奥地利维也纳R统计计算基金会)中进行统计分析。

结果

尽管未达到将LOS降低25%的初始目标,但这些干预措施共同使中位LOS从108.8分钟降至94.3分钟(降低了13.3%)。具体而言,儿科患者的LOS降低了10.2%,而成年患者的LOS降低了25.0%。

结论

创建结构化的工作人员角色、患者追踪器、检查表以及简化的出院流程,成功降低了学生运营诊所中儿科和成年患者的住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7ff/12433599/66ad0ffea215/cureus-0017-00000090146-i01.jpg

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