Brandt C P, Yurko L, Coffee T, Fratianne R
Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio 44109-1998, USA.
J Burn Care Rehabil. 1998 Sep-Oct;19(5):406-8. doi: 10.1097/00004630-199809000-00009.
Burn centers are under continuing pressures to lower costs and maintain quality of care. One method of achieving this goal is to integrate inpatient and outpatient care in the burn unit. In 1991, our unit instituted an on-site outpatient clinic that was expanded significantly in 1996. The clinic is staffed by the inpatient personnel and allows for 24-hour availability and accommodation of all nurse and physician visits. The number of outpatient visits has increased from 1604 in 1992 to 4728 in 1996, despite a 33% reduction in registered nurse staffing during this time. From 1990 to 1996, the average length of inpatient stay for burns of 0% to 5% total burn surface area (TBSA), 6% to 10% TBSA, and 11% to 15% TBSA has decreased from 7.5 to 3.7 days, 10.3 to 7.7 days, and 16.6 to 11.8 days, respectively. Complete integration of inpatient and outpatient burn care can be achieved. An expanded on-site outpatient facility leads to optimal continuity of care, outpatient management of a larger percentage of burn injuries, and a shift in census from the inpatient to outpatient settings.
烧伤中心一直面临着降低成本和维持护理质量的持续压力。实现这一目标的一种方法是在烧伤科整合住院和门诊护理。1991年，我们科室设立了一个现场门诊诊所，该诊所在1996年进行了大幅扩建。该诊所由住院部人员配备，可提供24小时服务，并能接待所有护士和医生的来访。尽管在此期间注册护士的配备减少了33%，门诊就诊人数仍从1992年的1604人次增加到了1996年的4728人次。从1990年到1996年，烧伤总面积为0%至5%、6%至10%以及11%至15%的患者平均住院天数分别从7.5天降至3.7天、从10.3天降至7.7天以及从16.6天降至11.8天。住院和门诊烧伤护理的完全整合是可以实现的。一个扩大的现场门诊设施能够带来最佳的护理连续性、对更大比例烧伤损伤的门诊管理，以及患者从住院向门诊环境的转移。
