"三线防控"模式在新冠肺炎疫情期间妇产科患者门诊就诊管理实践探讨

目的探讨新冠肺炎疫情期间"三线防控"模式在广州医科大学附属第三医院妇产科门诊的实践成效。 方法自新冠肺炎疫情以来,我院妇产科门诊自主制定了"三线防控"模式并常态化实施,采用回顾性研究方法分析2021年3月至8月广州市荔湾区疫情前后我院妇产科普通门诊、急诊及发热门诊的患者就诊情况,重点分析5~6月普通门诊中发现健康码异常或流行病学史的漏诊率、普通门诊的实际就诊率及候诊时间、患者满意度、发热门诊会诊率、妇科门诊手术情况、产科患者收住院情况等,同比2020年及2019年5~6月我院妇产科患者就诊情况变化。 结果在2021年广州市荔湾区疫情期间的5~6月,我院妇产科门诊累计预检分诊33 782例,其中黄码患者73例,健康码正常但流行病学史疑似患者108例,最终确诊新冠肺炎患者0例。2021年5月患者就诊同比2020年上升了6.09%,但较疫情前的2019年下降11.6%;6月患者就诊同比2019年及2020年分别明显下降了40.73%及41.51%。2021年5月21日至7月2日妇产科普通门诊患者的实际就诊率平均为90.8%,呈逐渐增长的趋势。2021年5~6月妇产科门诊手术总数为2501例,总收住院人数为1286例,收住院患者中持有72 h有效新冠核酸阴性结果的占比100%,隔离病房的收治情况为0;患者的就诊满意度平均高达8.76分。 结论"三线防控"管理模式,建立有效的普通门诊应急反应体系,保障了不同状况、不同需求的患者得到及时诊治,为广大患者安全就医提供了坚实的保障,并获得较高的满意度。

"Three-line prevention and control" management model of obstetrics and gynecology outpatient patients during the epidemic of COVID-19

ObjectiveTo explore the effectiveness of the "three-line prevention and control" mode of pre-examination and triage management in the Department of Obstetrics and Gynecology of the Third Affiliated Hospital of Guangzhou Medical University during the COVID-19 epidemic. MethodsThe general obstetrics and gynecology outpatient department formulated the "three line control" mode and normalized implementation. Retrospective analysis of patients in the department of general obstetrics and gynecology, emergency department and fever department before and after the epidemic in Liwan District, Guangzhou, from March to August 2021, compared with the patients' visits in 2020 and 2019 in the same period. Data was collected, which included rate of missed diagnosis in general outpatient department with abnormal health code or epidemiological history, actual rate and waiting time of general outpatient department, emergency rate of obstetrics and gynecology, satisfaction survey, consultation rate of fever outpatient department, number and type of outpatient surgeries, admission and hospitalization of obstetrics patients. ResultsDuring this period, a total of 33, 782 cases of pre-examination and triage were performed in the outpatient department of obstetrics and gynecology in our hospital. Among them, there were 73 yellow code patients, 108 suspected patients with normal health code but epidemiological history, and 0 confirmed COVID-19 patients. From May to June of 2021, the outpatients in our hospital increased by 6.09% in May compared with 2020, and significantly decreased by 40.73% and 41.51% in June compared with 2019 and 2020, respectively. The actual attendance rate averaged about 90.8 percent from May 21th to July 2th, 2021, and showed a trend of gradual growth. A total of 2501 outpatient surgeries were performed during the COVID-19 pandemic. The total number of hospitalized patients was 1286, and 100% of the hospitalized patients had negative results of COVID-19 nucleic acid valid for 72 hours. The number of patients admitted to the isolation ward was 0. The average satisfaction rate of patients was as high as 8.76. ConclusionsAs a Guangzhou medical center for critical pregnant women, through the "three line control" mode, an effective emergency response system has been established in the general outpatient department. The outpatients with different conditions and requirements can guarantee the timely diagnosis and treatment. Meanwhile, thus avoiding high-risk groups from entering the general waiting area and providing a solid guarantee for the safety of patients seeking medical treatment.