Walsh C M, Coldiron J S
Carney Hospital, Boston, MA.
Am J Med Qual. 1993 Fall;8(3):128-33. doi: 10.1177/0885713X9300800304.
Traditional data collection in discharge planning programs has been largely retrospective, measuring the patient's length of stay and unnecessary hospital days at the point of discharge. Although the data collection is useful, it does not lend itself to corrective actions on a concurrent basis. Carney Hospital has developed a data base that monitors patient status daily in order to identify when a length of stay problem is developing and when corrective actions are succeeding. The Patient Tracking System is an interactive computer report utilized by Continuing Care staff, Utilization Review staff, and clinical managers on the patient care units. It is a caseload register that operates from the admission transfer discharge (A/T/D) system of the hospital and sorts inpatients by discharge planning status, length of stay, discharge planning worker, and nursing unit. It is the basis for a weekly management review that identifies numbers of patients and average length of stay to date of key groups of patients proven to impact the overall length of stay in the hospital. Carney Hospital has successfully utilized this system to alert managers to any length of stay "creep," to identify the sources of the length-of-stay problem, and to mobilize key personnel to take corrective actions. The system is easy to use and is an effective length-of-stay management tool.
出院计划项目中的传统数据收集大多是回顾性的,在出院时衡量患者的住院时间和不必要的住院天数。虽然这种数据收集很有用,但它并不适合同时采取纠正措施。卡尼医院开发了一个数据库,每天监测患者状况,以便确定住院时间问题何时出现以及纠正措施何时取得成功。患者跟踪系统是一个交互式计算机报告,由持续护理人员、利用审查人员和患者护理单元的临床管理人员使用。它是一个病例负荷登记册,根据医院的入院-转院-出院(A/T/D)系统运行,并按出院计划状态、住院时间、出院计划工作人员和护理单元对住院患者进行分类。它是每周管理审查的基础,该审查确定已证明对医院总体住院时间有影响的关键患者群体的患者数量和迄今为止的平均住院时间。卡尼医院已成功利用该系统提醒管理人员注意任何住院时间的“攀升”,确定住院时间问题的根源,并动员关键人员采取纠正措施。该系统易于使用,是一种有效的住院时间管理工具。