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首页> 外文期刊>Journal of Hospital Administration >Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study
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Applying quality improvement principles to improve accident and emergency department overcrowding and flow in Rwanda: a case study

机译：运用质量改进原则改善卢旺达急诊和应急部门的人满为患情况

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Few case studies exist related to hospital accident and emergency department (A&E) quality improvement efforts in lowerresourced settings. We sought to report the impact of quality improvement principles applied to A&E overcrowding and flow in the largest referral and teaching hospital in Rwanda. A pre- and post-intervention study was conducted. A linked set of strategies included reallocating room space based on patient/visitor demand and flow, redirecting traffic, establishing a patient triage system and installing white boards to facilitate communication. Two months post-implementation, the average number of patients boarding in the A&E hallways significantly decreased from 28 (pre-intervention) to zero (post-intervention), p p p < .001). One hundred percent of the A&E patients have been formally triaged since the implementation of the newly established triage system. Our project used quality improvement principles to reduce the number of patients boarding in the hallways and to decrease unnecessary foot traffic in the A&E department with little investment from the hospital. Key success factors included a collaborative multidisciplinary project team, strong internal champions, data-driven analysis, evidence-based interventions, senior leadership support, and rapid application of initial implementation learnings. Results to date show the application of quality improvement principles can help hospitals in resource-limited settings improve quality of care at relatively low cost.
机译：很少有案例研究与资源匮乏地区的医院事故和急诊科（A＆E）质量改进工作相关。我们试图报告在卢旺达最大的转诊和教学医院中，将质量改进原则应用于急诊室拥挤和流动的影响。进行了干预前后的研究。一套相互关联的策略包括根据患者/访客的需求和流量重新分配房间空间，重定向流量，建立患者分诊系统以及安装白板以促进沟通。实施后两个月，急症室的平均登机人数从28（干预前）降至零（干预后），p p p <.001）。自从新建立的分诊系统实施以来，有100％的A＆E患者已被正式分诊。我们的项目使用质量改进原则，以减少医院登机的人数，并减少急诊科不必要的人流，而医院的投资却很少。成功的关键因素包括一个协作的多学科项目团队，强大的内部拥护者，数据驱动的分析，基于证据的干预措施，高层领导的支持以及对初始实施的学习的快速应用。迄今为止的结果表明，质量改进原则的应用可以帮助资源有限的医院以相对较低的成本改善医疗质量。

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