一站式入院智能床位管理系统的设计与应用

目的 优化入院流程,实现床位智能管理。方法 利用全流程信息化对整个入院流程进行整合再造,构建智能床位管理系统。结果 建立了一站式入院智能床位管理系统,实现了全院床位智能化管理和患者入院的精准化管理,减少了患者入院等待时间。结论 通过优化患者入院服务流程,方便了患者;通过预约排队规则和床位确认自动同步,实现了床位智能管理。     

住院服务中心模式流程再造的探索与实践

通过推进电子化预约登记,整合＂预约登记、安排入院、入院检查、出院随访＂服务流程,以信息化统筹全院床位,再造了入院流程。住院服务中心模式的实施,缩短了患者入院前等候时间,简化了入院手续办理和入院后检查检验流程,缩短了患者平均住院日,提高了床位使用率。     

信息化下入院服务全流程再造

目的 优化入院服务流程,提高医疗服务质效,提升就医体验.方法 运用系统理论和流程管理理论,基于信息化支撑再造入院服务全流程.结果 信息化入院服务全流程再造实现一站式入院服务,缩短患者及家属时间,减少患者折返,提升床位使用率和患者满意度.结论 基于信息化支撑的入院服务全流程为优化、改善医疗服务提供借鉴.     

常态化疫情防控下入院流程的创新与实践

目的 为深入落实智慧医院建设,结合疫情防控要求,重塑患者入院服务流程,优化资源配置,提高入院服务品质与服务满意度。方法 结合目标检测、动作识别等人工智能技术,研发实施入院登记、陪护登记、智能院感行为监管、核酸检测、通行管控等信息化系统对患者入院流程进行创新改造。结果 建立了完善的防疫工作管理体系,实现了患者一站式入院服务与院中智慧闭环管理。结论 优化后的服务流程显著提高了入院服务效率,提升了患者满意度,有效保障了院内疫情期间的防控工作,成效显著。     

信息化预约模式在三级综合医院入院流程中的应用效果评价

目的：通过在三级医院入院流程中实施信息化预约模式,建立“门诊-住院”的无缝隙衔接,缩短患者入院等待时间,充分利用医院床位资源,提高患者满意度。方法：通过对信息化预约模式实施前后入院流程、入院耗时、效率比、满意度、床位使用率等指标的对比分析,评价其在三级医院入院流程中的应用效果。结果：信息化预约模式实施后,1、入院流程简化,入院动线缩短;2、入院办理时间从原来的（57.29±2.51）分钟缩短到（35.79±1.78）分钟,有效时间占比从52.36%提升至83.82%,患者满意度从54.88%上升到89.89%;3、床位使用率由91.5%上升至92.7%。结论：信息化预约模式的应用明显缩短了患者入院办理及等待时间,提高了患者及其家属的满意度,提升了医院床位资源的利用率。     

优化的入院流程在心脏外伤患者救治中的应用

为了缩短心脏外伤患者入院时间,提高救治效率和救治质量,应用优化入院流程为患者急救赢得宝贵时间,降低死亡率,提高了患者生存质量和满意度。     

三级医院入院流程的现状调查和对策研究

目的探讨三级医院入院流程服务效率的影响因素,为医院开展患者入院流程优化与再造工作,提高入院流程效率和入院患者满意度提出参考意见。方法采用现场调查方式,于2015年6—12月对入院患者进行调查,共发放205份调查问卷,观察医院工作人员和患者的行为情况,采用自拟满意度调查表,分层抽样和调查入院患者的满意及其期望情况。所有数据采用χ2检验、t检验、方差分析和线性回归等方法进行分析,计量资料两两比较采用LSD法,P0.05为差异有统计学意义。结果不同年龄、文化程度、住院次数、陪护人员患者的总体满意度比较,差异均有统计学意义(均P0.05)。58.2%(113/194)的患者能够接受5~15 min内办理完入院,34.0%(66/194)的患者希望入院流程的时间控制在5 min以下,7.7%(15/194)的患者能够接受15~30 min内办理完入院。线性回归分析显示,文化程度、住院次数和陪同人员为总满意度的影响因素。结论从门诊医患的沟通方式、医院信息管理系统的顶层设计、建筑布局和医院标识导向系统、入院患者陪同和岗位工作规范等方面强化管理,可提高患者入院的满意度和流程效率。     

射频识别系统在手术患者安全管理中的应用

目的研究手术患者安全识别流程并分析存在问题,运用RFID(Radio Frequency Identification,射频识别)信息技术解决安全隐患。方法以现有计算机信息系统为基础,设计RFID 手术患者安全的硬件、软件结构,并制定手术患者安全辨识标准作业流程,以实现手术患者安全的信息化管理。结果在为期3个月的手术患者安全管理临床效果评估中,手术流程核查正确率为100％。结论RFID手术患者安全管理系统能简化手术室患者的辨识流程,并实现系统的自动核对,提升了手术患者正确辨识率及医疗安全,保障了手术患者安全。     

流程再造在护理环节管理中的应用

[目的]探讨流程再造对护理服务效果的影响。[方法]对入院流程、点眼流程、交接班流程、手术接送流程实行流程再造,对流程再造前后效果予以评价。[结果]流程再造后患者入院时间由8～10min缩短至3min,眼水治疗按时性由差值40min缩短至平均10min,管床护士对患者信息的知晓率由改造前的32.46%提高到90.2%。患者满意率由再造前的93.4%提高到97.78%。[结论]流程再造有利于提高护理服务质量提高病人满意度。     

湘雅医院:破解患者入院困局

正当前,我国医疗卫生领域存在优质医疗资源相对不足、分布不均衡等问题。反映到大医院,一个重要表现便是患者入院难、候床时间长、入院手续繁琐。中南大学湘雅医院虽然拥有编制床位3500张,但不少省市的患者慕名而来,入院困局尤其突出。院前准备中心:发挥集中预约优势传统入院流程存在诸多弊端。例如,流程复杂,患者需多次往返于门诊、     

基于快速康复的日间手术护理质量探索

目的探索基于快速康复理念的日间手术护理质量管理模式,提高护理管理水平。方法对存在问题进行分析,采用全程风险管理、规范标准制定、过程质量监控、核心能力培养、多元健康宣教、术后延续照护等措施,进行护理质量管理。结果入院前评估完成率、入院前爽约率、患者满意度、7天内非计划再入院率、不良事件或纠纷比例等核心指标均得以改善。结论推行基于快速康复理念的日间手术护理质量管理模式,可以保障诊疗安全、优化服务流程、改善患者体验等。     

公立医院医保患者入出院流程的优化

目的:通过对医保患者入出院服务流程的优化,提高患者办理入出院流程的效率,提高满意度。方法:分析某公立三甲医院医保患者入出院价值流程,计算有效时间占比,找出引起效率低下的原因并提出改进办法。结果:优化流程后,医保患者入院流程有效时间占比由20%提升至36%,出院流程有效时间占比由9%提升至29%。结论:对公立医院医保患者入出院服务流程的优化,可明显提高患者办理入出院流程的效率,提升医疗服务质量。     

Hospital Preparations for Viral Hemorrhagic Fever Patients and Experience Gained from Admission of an Ebola Patient

The Major Incident Hospital of the University Medical Centre of Utrecht has a longstanding history of preparing for the management of highly pathogenic and infectious organisms. An assessment of the hospital’s preparations for an outbreak of viral hemorrhagic fever and its experience during admission of a patient with Ebola virus disease showed that the use of the buddy system, frequent training, and information sessions for staff and their relatives greatly increased the sense of safety and motivation among staff. Differing procedures among ambulance services limited the number of services used for transporting patients. Waste management was the greatest concern, and destruction of waste had to be outsourced. The admission of an Ebola patient proceeded without incident but led to considerable demands on staff. The maximum time allowed for wearing personal protective equipment was 45 minutes to ensure safety, and an additional 20 minutes was needed for recovery.     

A latent variable approach to potential outcomes for emergency department admission decisions

In emergency departments (EDs), care providers continuously weigh admissions against continued monitoring and treatment often without knowing their condition and health needs. To understand the decision process and its causal effect on outcomes, an observational study must contend with unobserved/missing information and a lack of exchangeability between admitted and discharged patients. Our goal was to provide a general framework to evaluate admission decisions from electronic healthcare records (EHRs). We describe admission decisions as a decision-making process in which the patient's health needs is a binary latent variable. We estimate latent health needs from EHR with only partial knowledge of the decision process (ie, initial evaluation, admission decision, length of stay). Estimated latent health needs are then used to understand the admission decision and the decision's causal impact on outcomes. For the latter, we assume potential outcomes are stochastically independent from the admission decision conditional on latent health needs. As a case study, we apply our approach to over 150 000 patient encounters with the ED from the University of Michigan Health System collected from August 2012 through July 2015. We estimate that while admitting a patient with higher latent needs reduces the 30-day risk of revisiting the ED or later being admitted through the ED by over 79%, admitting a patient with lower latent needs actually increases these 30-day risks by 3.0% and 7.6%, respectively.     

The demand for elective surgery in a public system: time and money prices in the UK National Health Service

We construct a model of the admission process for patients from general practices for elective surgery in the UK National Health Service. Public patients face a positive waiting time, but a zero money price. Fundholding practices faced a positive money price for each patient admitted. The model is tested with data on general practice admission rates for cataract procedures in an English Health Authority. Admission rates are negatively related to waiting times and distance to hospital. Practices respond to financial incentives as predicted by the model: fundholding practices have lower admission rates than non-fundholders and respond differently to changes in waiting times and patient characteristics.     

Preadmission nutrition screening: expanding hospital-based nutrition services by implementing earlier nutrition intervention

The need to screen patients earlier than within the first 24 hours of hospital admission has resulted in the development of preadmission nutrition screening. At Providence Saint Joseph Medical Center (PSJMC), a 455-bed acute-care facility, this procedure has been used since 1994. The preadmission screening method was developed because of the use of critical pathways for patients in specific diagnosis-related groups. Critical pathways specified that registered dietitians must assess these patients within 24 hours of admission at PSJMC. However, at that time there was minimal data in the chart from which to assess the patient's nutritional status and the ability to interview the patient was often limited as a result of intubation or postoperative pain. Family members were not always available at the hospital to discuss a patient's preadmission nutritional status. To address this problem, we developed a system to call people at home before their admission to the hospital to obtain specific nutrition information. To analyze the effectiveness of the procedure, the Food and Nutrition Services Department developed a process to assess this method of screening and to improve the system. Patients were enrolled in a study over a 1-month period, demographics were identified for this sample population, and patient satisfaction was determined via an interview conducted by a dietetic technician after the patient was admitted. Most patients found this to be a very helpful process and an example is presented here on the role of preadmission nutrition screening in improving patient outcome. To better define the population of the case study presented, additional information was gathered on a second study group of patients screened before admission who were admitted for hip and knee surgery, one of the specific diagnosis-related groups with a critical pathway. Our findings indicate that preadmission nutrition screening has the potential to improve patient outcomes by increasing nutrient intake before their hospital admission, reducing hospitalization length, and enhancing patient satisfaction during their hospital stay.     

临床路径模式下的垂体瘤患者满意度研究

目的 研究实施临床路径前后垂体瘤患者满意度变化,为完善垂体瘤临床路径管理、提高医疗质量提供决策参考.方法 运用列联表分析、卡方检验和T检验等方法,分析实施临床路径前后垂体瘤患者满意度的差异.结果 实施临床路径前后垂体瘤患者入院过程满意度不存在显著差异,而医疗环境设施、医疗服务、诊疗结果、医疗费用、知情同意满意度以及总体...     

普外疾病伴发精神障碍病人的护理风险

探讨普外疾病伴发精神障碍病人护理过程中存在着医、护系统评估不全;护理人员对伴发精神障碍病人认知和护理能力不强,防范意识不高;住院环境、设施、制度不完善;病人及家属的依从性差等风险因素.提出做好入院系统评估,提高安全防范意识,强化宣教与沟通,提高护理安全和质量.