Abstract:

Objective To explore the impact of optimizing emergency pre-examination triage process on waiting accidents, medical disputes, waiting time, and waiting response time coincidence rate in cerebrovascular disease patients. Methods This retrospective study included patients with cerebrovascular disease from Department of Emergency of Beijing Tiantan Hospital, Capital Medical University from January to October 2019. According to the time point of starting the process optimization in June, 2019, all the subjects were divided into the pre-optimization process group and post-optimization process group. The waiting accidents and medical disputes, waiting time, and coincidence rate of waiting response time of the two groups were compared, and the waiting time of patients entering into the cerebrovascular disease fast track in the two groups were also compared. Results A total of 10 716 patients were included in this study, including 5695 cases in preoptimization process group and 5021 cases in post-optimization process group. Compared with the pre-optimization process group, the post-optimization process group had lower waiting accidents (0.4% vs 2.0%, P =0.038) and medical disputes (0.3% vs 1.3%, P =0.033), shorter waiting time (11.6±1.4 min vs 25.1±3.5 min, P =0.025), higher coincidence rate of waiting response time (89.1% vs 75.2%, P =0.024), and shorter waiting time of entering into fast track (2.2±0.7 min vs 6.6±1.2 min, P =0.032).

Conclusions Optimizing emergency pre-examination triage process can effectively improve the coincidence rate of waiting response time in patients with cerebrovascular disease, reduce the incidence of waiting accidents and medical disputes, and shorten the waiting time of patients.

Key words: Cerebrovascular disease; Emergency; Pre-Examination triage; Process Optimization; Waiting response time

摘要：

目的 探讨急诊预检分诊流程优化对脑血管病患者候诊意外、医疗纠纷、候诊时间及候诊响应时 长符合率等的影响。 方法 回顾性选取2019年1-10月于首都医科大学附属北京天坛医院急诊就诊的脑血管病患者，以 预检分诊流程优化实施（2019年6月）为节点，分为优化前流程组（2019年1-6月）和优化后流程组 （2019年7-10月）两组，比较两组的候诊意外、医疗纠纷发生率、平均候诊时间、候诊响应时长符合率， 并进一步比较两组进入脑血管病绿色通道患者的候诊时间。 结果 研究共纳入10 716例患者，优化前流程组5695例，优化后流程组5021例。优化后流程组患者 的候诊意外（0.4% vs 2.0%，P =0.038）、医疗纠纷发生率（0.3% vs 1.3%，P =0.033）均低于优化前流 程组；平均候诊时间短于优化前流程组（11.6±1.4 min vs 25.1±3.5 mi n，P =0.025）；候诊响应时长符 合率高于优化前流程组（89.1% vs 75.2%，P =0.024）。优化后流程组脑血管病绿色通道患者的候诊 时间短于优化前流程组（2.2±0.7 min vs 6.6±1.2 mi n，P =0.032）。 结论 急诊预检分诊流程优化能够有效提升脑血管病患者候诊响应时长符合率，同时降低患者的 候诊意外、医疗纠纷发生率，缩短患者的平均候诊时间。

关键词: 脑血管病; 急诊; 预检分诊; 流程优化; 候诊响应时长