Effect of limitation in flow of people on medical care quality in emergency resuscitation room
10.3760/cma.j.issn.1671-0282.2018.07.024
- VernacularTitle:限制抢救室人流量对急诊医疗质量的影响
- Author:
Shihai XU
1
;
Suili GUAN
;
Manying XIE
;
Huirong LIN
;
Fei SHI
;
Jin WANG
;
Aijun SHAN
Author Information
1. 暨南大学第二临床医学院深圳市人民医院急诊中心
- Keywords:
Emergency resuscitation room;
Flow of people;
Medical care quality;
Hospital-acquired infection;
Mortality rate;
Green channel;
Satisfaction level
- From:
Chinese Journal of Emergency Medicine
2018;27(7):815-820
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of limitation in flow of people on medical care quality in emergency resuscitation room (ERR).Methods This study was retrospectively performed to compare emergency medical quality before and after (October to December,2015 vs.February to April,2016) limitation of flow of people in ERR.Variables included noise level,occupational exposure,adverse event,hospital-acquired infection,length of stay (LOS) in ERR,mortality rate,return of spontaneous circulation (ROSC) rate after cardiopulmonary resuscitation (CPR),the rate of unexpected return to ERR,door to drug and door to balloon time for patients with ST-segment elevated myocardial infarction (STEMI),patients' and emergency personnels' satisfaction level.The data were analyzed with t-test,chi-square test or Poisson Z test where appropriate.Results There were 5 031 and 5 097 patients respectively admitted in ERR before and after limitation of flow of people.Patients' main diagnoses and severity of illness between the two periods had no significantly difference (P＞0.05).After the limitation of flow of people,the noise level in ERR was lowered (P＜0.01),the numbers of occupational exposure events (14 cases vs.4 cases,Z=2.357,P=0.018) and adverse events (18 cases vs.5 cases,Z=2.711,P=0.007) were decreased,the rate of hospital-acquired infection was reduced (1.1％ vs.0.5％,x2=8.111,P=0.004),the LOS in ERR was shortened [(6.3±0.8) h vs.(4.6±0.6) h,t=121.083,P＜0.01],the door to balloon time for STEMI patients was also decreased [(91.2±12.8) min vs.(89.3±8.0) min,t=2.486,P=0.013].Moreover,patients' and emergency personnels' satisfaction level were elevated.No significant difference was observed in mortality rate,ROSC rate,rate of unexpected return to ERR and door to drug time for STEMI patients.Conclusions The limitation of flow of people in ERR can lower the noise level,reduce emergency personnels' working pressure,improve their working efficiency,avoid medical errors,elevate patients' and emergency personnels' satisfaction level.
