平均住院日影响因素及管理改进研究
Study on Influencing Factors of Average Length of Stay and Management Improvement
吴燕君 1谢清华 1刘凯捷 1毛鑫礼 1朱峰1
作者信息
摘要
目的 基于精益管理理念,借助循证医学工具分析某三级甲等医院的平均住院日现状及影响因素,通过实施改进和效果评价,旨在形成可推广复制的医院高效运营策略.方法 以某三级甲等医院为研究对象,使用CiteSpace进行文献可视化分析、结合医院现状找出影响因素;应用Spearman进行单因素分析和多因素Logistic回归分析,明确平均住院日的关键影响因素;提出实施针对性改进措施并实施效果评价.结果 影响平均住院日的主要因素为平均待术日、转诊率和临床路径管理率.改进后平均住院日由6.59 天下降至 5.94 天.结论 借助医院信息技术和医疗资源合理配置,优化收治流程、提升医技效率;落实双向转诊政策,引导患者合理流动,共建区域医疗合作圈;优化路径管理和考核,规范诊疗行为等措施,可有效缩短医院平均住院日,提高医院运行效率.
Abstract
Objective To form a scalable and replicable hospital efficient operation strategy based on the concept of lean management,the analysis of the current status and influencing factors of the average length of stay in a tertiary hospital with the help of evidence-based medicine tools,and the implementation of improvement measures and effect evaluation.Methods Taking a tertiary hospital as the research object,CiteSpace was used for literature visualization analysis,and the influencing factors were found out in combination with the current situation of the hospital.Spearman univariate analysis and multivariate Logistic regression analysis were used to identify the key influencing factors of the average length of stay.Targeted improvement measures and implementation effect evaluation were put forward.Results The main factors affecting the average length of stay were the average waiting days for surgery,referral rate and clinical pathway management rate.The average length of stay decreased from 6.59 days to 5.94 days.Conclusion With the help of hospital information technology and the rational allocation of medical resources,the treatment process is optimized and the efficiency of medical treatment is improved.The two-way referral policy should be implemented to guide the reasonable flow of patients,and regional medical cooperation alliance should be built.Measures such as optimizing pathway management and assessment,and standardizing diagnosis and treatment behaviors can effectively shorten the average length of stay and improve hospital operation efficiency.
关键词
平均住院日/精益管理/效果评价Key words
Average length of stay/Lean management/Effect evaluation引用本文复制引用
基金项目
浙江省医药卫生科技计划(2021KY1206)
恩泽医院管理研究青年基金(ENHM2020024)
出版年
2024
NETL
NSTL
万方数据