Heymann T D, Culling W
Department of Gastroenterology, Royal London Hospital.
J R Coll Physicians Lond. 1996 Mar-Apr;30(2):142-4.
It can take 2 hours of hospital staff time to obtain a routine chest X-ray, up to 47 clinical staff may be involved with a patient during a 5-day stay, and only a quarter of total costs may be for direct patient care, so some hospitals are experimenting with patient focused care by relocating services such as X-ray to the bedside, training ward staff in a wider range of skills, and managing care itself by using multidisciplinary protocols. Potential benefits can be measured in terms of reduced process times and faster turn-round, but duplication of, for example, high-tech pathology and radiology equipment is expensive, as is releasing staff for training. Proponents say that higher quality patient care will result without increased cost, and theoretical analyses suggest that advantages should outweigh disadvantages. The more established patient focused units in the UK are now over a year old; practical analyses of their quality and cost are under way.
获取一张常规胸部X光片可能需要医院工作人员2个小时的时间,在患者住院的5天时间里,可能有多达47名临床工作人员参与其中,而总费用中只有四分之一可能用于直接的患者护理,因此一些医院正在尝试以患者为中心的护理模式,比如将X光检查等服务转移到床边,培训病房工作人员掌握更广泛的技能,并通过多学科协议来管理护理工作本身。潜在的好处可以通过减少流程时间和更快周转来衡量,但例如高科技病理和放射设备的重复配置成本高昂,让工作人员去参加培训的成本也很高。支持者表示,在不增加成本的情况下将带来更高质量的患者护理,理论分析表明优势应大于劣势。英国那些成立时间较长的以患者为中心的科室现在已经成立一年多了;对其质量和成本的实际分析正在进行中。