在手术室恢复中提供创伤病床及其对创伤手术室效率的影响:来自一个大容量创伤科室的经验。

IF 1.1 4区 医学 Q3 SURGERY
J Saleem, O Brown, C Mclean, K Kurzatkowski, S Radha, R Mallina
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引用次数: 0

摘要

导言:众所周知,创伤环境中的效率低下问题因 COVID-19 大流行等因素而进一步恶化,因此国家出台了指导意见,以帮助提高资源利用率。本研究引入了一项由外科医生主导的新型干预措施--创伤恢复床,旨在提高创伤手术室的效率:该质量改进项目采用 "计划-实施-研究-行动"(Plan Do Study Act,PDSA)方法进行,包括多个评估手术室绩效的周期。采用多学科团队(MDT)方法,听取相关利益方的意见,实施干预措施,旨在促进 "黄金病人 "尽早到达麻醉室。主要结果是第一位患者进入麻醉室的时间,次要结果是每天完成的病例数:研究为期一年,包括三个 PDSA 周期。干预措施在 PDSA 循环 1 和 PDSA 循环 2 中分别取得了主要结果和次要结果,在统计学上有显著改善(p < 0.001)。一项子分析评估了干预措施的具体影响,结果表明,在按计划使用干预措施的情况下,两项结果均有明显改善(p < 0.0005):结论:环形围栏创伤床能明显缩短手术开始时间,从而提高手术效率。这是一项简单、实用的干预措施,不仅使 MDT 重创团队受益,还产生了持续的影响。鉴于国家医疗服务效率是国家医疗保健讨论的重点,我们建议在其他创伤科室实施这一干预措施,以帮助解决这一长期存在的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The provision of a trauma bed in theatre recovery and its impact on trauma theatre efficiency: experience from a high-volume trauma unit.

Introduction: Inefficiencies in the trauma setting are well known and have been further exacerbated by the COVID-19 pandemic among other factors, resulting in national guidance to aid improvements in resource utilisation. This study introduced a novel surgeon-led intervention, a trauma bed in recovery, with the aim of improving trauma theatre efficiency.

Methods: This quality improvement project was conducted using a Plan Do Study Act (PDSA) methodology and comprised multiple cycles to assess theatre performance. A multidisciplinary team (MDT) approach with relevant stakeholder input enabled intervention implementation, aimed at facilitating 'golden patient' arrival in the anaesthetic room as early as possible. The primary outcome was the time at which the first patient entered the anaesthetic room, and the secondary outcome was the number of cases performed each day.

Results: The study period was 1 year and encompassed three PDSA cycles. The intervention achieved its primary outcome by PDSA cycle 1 and its secondary outcome by PDSA cycle 2, demonstrating statistically significantly improved results (p < 0.001). A subanalysis assessed the specific impact of the intervention, and demonstrated a significant improvement in both outcomes when the intervention was used as intended (p < 0.0005).

Conclusions: A ringfenced trauma bed significantly improved theatre start times and thereby theatre efficiency. This is a simple, pragmatic intervention that benefitted the MDT trauma team while also demonstrating a sustained impact. Given that National Health Service efficiency is at the forefront of national healthcare discourse, we recommend that this intervention is implemented in other trauma units to help provide a solution to this longstanding issue.

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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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