院内多重耐药大肠埃希菌肺炎的耐药现状及影像学特征分析

目的 分析院内多重耐药大肠埃希菌(MDR-ECO)肺炎的耐药现状及影像学特征,并探讨发生MDR-ECO感染的危险因素.方法 选择2018-07-01～2020-06-30潍坊市人民医院经呼吸道或者血标本分离检测确认的大肠埃希菌所致院内获得性肺炎(HAP)患者178例的病历资料,根据致病菌是否为多重耐药菌将其分为MDR-...     

Implementation of Vertical Split Flow Model for Patient Throughput at a Community Hospital Emergency Department

BackgroundHospitals have implemented innovative strategies to address overcrowding by optimizing patient flow through the emergency department (ED). Vertical split flow refers to the concept of assigning patients to vertical chairs instead of horizontal beds based on patient acuity.ObjectiveEvaluate the impact of vertical split flow implementation on ED Emergency Severity Index (ESI) level 3, patient length of stay, and throughput at a community hospital.MethodsRetrospective cohort study of all ESI level 3 patients presenting to a community hospital ED over a 3-month period prior to and after vertical split flow implementation between 2018 and 2019.ResultsIn total, data were collected from 10,638 patient visits: 5262 and 5376 patient visits pre- and postintervention, respectively. There was a significant reduction in mean overall length of stay when ESI-3 patients were triaged with vertical split flow (251 min vs 283 min, p < 0.001).ConclusionsCommunity hospital ED implementation of vertical split flow for ESI level 3 patients was associated with a significant reduction in overall length of stay and improved throughput. This model provides a solution to increase the number of patients that can be simultaneously cared for in the ED without increasing staffing or physical space.