基于5M1E分析法的现场管理模式在自行来院高危胸痛患者中的应用

Application of on-site management model based on 5M1E in high-risk patients with chest pain coming to hospital by themselves

目的探讨基于5M1E分析法的现场管理模式在自行来院高危胸痛患者中的应用效果。方法选取2017年7月—2018年10月自行前往首都医科大学附属北京潞河医院就诊的高危胸痛患者263例为研究对象,其中以2017年7月—2018年2月行常规模式就诊患者为常规模式组(n=128),以2018年3—10月行基于5M1E分析法的现场管理模式就诊患者为现场管理模式组(n=135)。记录并比较两组到达急诊科大门时间(D)-首份心电图时间、D-采血时间、采血时间-胸痛生物标志物结果时间、入导管室患者的D-离开急诊时间、行介入治疗患者的D-球囊扩展时间(D2B)以及2种模式下的急诊胸痛患者的救治时间。结果两组患者的D-首份心电图时间、D-采血时间、采血时间-胸痛生物标记物结果时间、D-离开急诊时间比较,差异均有统计学意义(P<0.05);两组患者D2B时间比较,差异无统计学意义(P>0.05)。结论基于5M1E分析法的现场管理模式可以有效缩短自行来院就诊的高危胸痛患者的就诊、救治时间,值得临床推广。

Objective To explore the effects of on-site management model based on 5M1E in high-risk patients with chest pain coming to hospital by themselves.Methods Totally 263 high-risk patients with chest pain who went to Beijing Luhe Hospital,Capital Medical University by themselves from July 2017 to October 2018 were selected.Patients who received routine management from July 2017 to February 2018(n=128)were included into the routine management group,while patients who received on-site management based on 5M1E from March to October 2018(n=135)were included into the on-site management group.The arrival time at the emergency department gate(D)-first ECG time,D-blood collection time,blood collection time-chest pain biomarker result time,D-time of leaving emergency department for patients entering the catheterization room,D-balloon expansion time(D2B)for patients undergoing interventional therapy,and the treatment time of emergency patients with chest patients of the two groups of patients were recorded and compared.Results The difference in D-first ECG time,D-blood collection time,blood collection time-chest pain biomarker result time,and D-time of leaving emergency department between the two groups of patients was statistically significant(P<0.05),whereas there was no statistically significant difference in D2B between the two groups(P>0.05).Conclusions The on-site management model based on 5M1E can effectively shorten the time for consultation and treatment of high-risk patients with chest pain who come to the hospital by themselves,which is worth promoting in clinical practice.