病人路径的过程改进:应用分解法加速纵向设计的案例研究。

IF 1.7 4区 医学 Q3 HEALTH POLICY & SERVICES
Aske Skouboe, Z. Hansen, Jan Kloppenborg MØller
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引用次数: 0

摘要

对长期慢性患者途径改善的评估必须包括对患者的短期和长期影响;也就是对整个患者通路的影响。否则,可能会在不考虑长期影响的情况下削减成本,因此,该途径的总成本可能会增加。不幸的是,当前的评估方法存在几个问题:(1)直到几年之后,它们才提供关于给定改进工作效果的有效见解;(2)它们提供的结果不精确且有偏差;(3)汇总的结果对于识别和传播导致改进的最佳实践没有用处。在这篇文章中,加速纵向设计与总成本分解(ALDD)方法应用于评估改善努力对长期心脏路径的住院病人利用在丹麦医院的影响。结果表明,ALDD方法可以比传统方法更快地提供有效结果,并且可以发现临床团队本地工作流程中隐藏的改进。在丹麦的一家医院应用ALDD方法发现,每条心脏通路的平均总床位利用率显著降低(15.4%),并表明这种降低是由于工作流程的改进造成的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Process Improvement in Patient Pathways: A Case Study Applying Accelerated Longitudinal Design With Decomposition Method.
EXECUTIVE SUMMARY Evaluations of improvements in long chronic-patient pathways must include both short- and long-term effects on patients; that is, effects on the full patient pathway. Otherwise, costs might be cut without considering the long-term effects and, consequently, the overall cost of the pathway could increase. Unfortunately, current methods of evaluation present several issues: (1) they do not provide valid insights regarding the effects of a given improvement effort until several years later, (2) they provide imprecise and biased results, and (3) the aggregated results are not useful for identifying and disseminating the best practices that lead to an improvement. In this article, the accelerated longitudinal design with decomposition of total costs (ALDD) method is applied to evaluate the effects of improvement efforts on inpatient utilization for long cardiac pathways at a Danish hospital. The results show that the ALDD method can deliver valid results much faster than traditional methods and can uncover hidden improvements in the local work processes of clinical teams. Application of the ALDD method at a hospital in Denmark identified a significant reduction (15.4%) in the mean total bed utilization per cardiac pathway and revealed that this reduction was caused by improvements in the work processes.
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来源期刊
Journal of Healthcare Management
Journal of Healthcare Management HEALTH POLICY & SERVICES-
CiteScore
2.00
自引率
5.60%
发文量
68
期刊介绍: The Journal of Healthcare Management is the official journal of the American College of Healthcare Executives. Six times per year, JHM offers timely healthcare management articles that inform and guide executives, managers, educators, and researchers. JHM also contains regular columns written by experts and practitioners in the field that discuss management-related topics and industry trends. Each issue presents an interview with a leading executive.
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