Christina Chong, Travis Watai, Jatinder Lachar, Yoshito Nishimura
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引用次数: 0
Abstract
Background: Efficient discharge planning is crucial for improving hospital capacity and patient care. Multidisciplinary rounds (MDRs) have been shown to enhance communication and coordination, yet their impact on resident teaching teams' discharge efficiency is less studied.
Aims: To examine how embedding dedicated case managers (CMs) and social workers (SWs) into internal medicine (IM) resident teams impacts discharge efficiency.
Methods: We conducted a retrospective cross-sectional study at The Queen's Medical Center comparing two resident multidisciplinary teaching (MDT) teams that included dedicated CMs and SWs with two resident standard care teams over an 8-month period (October 18 2023-June 25 2024). The outcomes assessed included length of stay (LOS), expected discharge date (EDD) accuracy, readmission rates and the rate of conditional discharge orders placed.
Results: A total of 1944 patients were included. The MDT teams showed significantly improved EDD accuracy (72.0% vs 66.7%, P = 0.0120) and more frequently placed conditional discharge orders (61.7% vs 43.8%, P < 0.0001) compared to standard care teams. No significant difference was observed in LOS or readmission rates.
Conclusion: Embedding dedicated CMs and SWs within resident teams improved EDD accuracy and the rate of conditional discharge orders placed, suggesting an opportunity to integrate MDRs as a standard within IM residency training to enhance discharge planning efficiency.
背景:有效的出院计划是提高医院容量和病人护理的关键。多学科查房(mdr)已被证明可以加强沟通和协调,但其对住院教学团队出院效率的影响研究较少。目的:研究将专门的病例管理人员(CMs)和社会工作者(SWs)嵌入内科(IM)住院团队对出院效率的影响。方法:我们在女王医学中心进行了一项回顾性横断面研究,比较了两个住院多学科教学(MDT)团队,包括专门的CMs和SWs,以及两个住院标准护理团队,为期8个月(2010月18日至2024年6月25日)。评估的结果包括住院时间(LOS)、预期出院日期(EDD)准确性、再入院率和有条件出院令的发生率。结果:共纳入患者1944例。MDT团队的EDD准确率显著提高(72.0% vs 66.7%, P = 0.0120),并且更频繁地发布有条件出院单(61.7% vs 43.8%, P)。结论:在住院医师团队中嵌入专门的CMs和SWs提高了EDD的准确性和有条件出院单的发布率,表明有机会将mdr作为住院医师培训的标准,以提高出院计划效率。
期刊介绍:
The Internal Medicine Journal is the official journal of the Adult Medicine Division of The Royal Australasian College of Physicians (RACP). Its purpose is to publish high-quality internationally competitive peer-reviewed original medical research, both laboratory and clinical, relating to the study and research of human disease. Papers will be considered from all areas of medical practice and science. The Journal also has a major role in continuing medical education and publishes review articles relevant to physician education.