防止救护车交接延误造成伤害的战略解决方案。

Cliff Evans, Adebayo Da'Costa
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引用次数: 0

摘要

当急诊科人满为患时,救护车交接就会出现延误,因为等待入院的病人长时间占用了为方便评估和治疗急诊病人而设计的诊室。为此,许多机构开始依赖将等待入院的急性病人临时安置在走廊等未指定的护理区域,以提供额外的空间。这样做的结果是,病人极有可能受到本可避免的伤害、侮辱和心理创伤,并对医护人员的健康产生负面影响,因为不可接受的护理标准已成为常态。作者所在的急诊信托机构分两个阶段实施了一项战略性质量改进项目。2020 年 11 月 2 日至 2021 年 7 月 26 日期间的救护车交接数据为该项目提供了基准。第一阶段在 2021 年 11 月 2 日至 2022 年 7 月 26 日期间实施,旨在减少 60 分钟的救护车交接延误。第二阶段在2022年11月2日至2023年7月26日期间实施,旨在消除60分钟的救护车交接延误并提高整体绩效。第一阶段将60分钟救护车交接延误时间减少了32%。第二阶段将60分钟救护车交接延误时间减少了97%。在项目实施过程中,15 分钟内完成的交接增加了 24%。该项目展示了医疗团队之间的战略规划和协作如何能够减少对患者造成可避免伤害的可能性,同时促进员工的福利和留任。
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A strategic solution to preventing the harm associated with ambulance handover delays.

Ambulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised. A two-phase strategic quality improvement project was implemented at the authors' acute trust. Ambulance handover data from between 2 November 2020 and 26 July 2021 provided a benchmark for the project. The first phase was implemented between 2 November 2021 and 26 July 2022 and aimed to reduce 60-minute ambulance handover delays. The second phase was implemented between 2 November 2022 and 26 July 2023 and aimed to eradicate 60-minute ambulance handover delays and improve overall performance. Phase one resulted in a 32% reduction in 60-minute ambulance handover delays. Phase two resulted in a 97% reduction in 60-minute ambulance handover delays. Over the course of the project there was a 24% increase in handovers completed within 15 minutes. This project demonstrates how strategic planning and collaboration between healthcare teams can reduce the potential for avoidable patient harm, while simultaneously promoting workforce well-being and retention.

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