基于急诊急救信息系统的急危重症救治“零通道”建设实践

Practice of"zero channel"construction in emergency and critical illness based on emergency and first-aid information system

目的探讨基于急诊急救信息系统的急危重症救治“零通道”建设实践及成效。方法全面梳理南方医科大学珠江医院原有急危重症救治流程,查找旧流程中可改善的环节。2021年1月引进急诊急救信息系统,运用精益管理理念,建设急危重症“零通道”救治流程并运用于实践,通过病例回顾,比较2020年1~12月旧流程和2021年1~12月“零通道”救治流程的效果。结果实施“零通道”救治流程前后急诊患者抢救成功率分别为95.78%及98.26%,实施后显著提高急危重症抢救成功率(P<0.05)。急性创伤重症患者“黄金1小时”内手术率达84.84%,平均入院至CT完成时间(12.06±1.96)min,平均入院至手术开始时间(27.51±4.52)min;胸痛患者急诊手术平均时间(64.99±6.26)min,卒中患者溶栓平均时间(45.28±6.95)min,各急救时间与“零通道”实施前比较均显著下降(P<0.05)。结论基于急诊急救信息系统的急危重症“零通道”救治流程可缩短各急救环节中需等待的时间,减少浪费,提高急救效率,确保患者安全。赢得了患者抢救的“黄金”时间,获得了更好的急救效益和患者满意度。

Objective To explore the practice and effect of"zero channel"construction for emergency and critical illness based on the emergency and first-aid information system.Methods To comprehensively sort out the original emergency and critical care treatment process,and to find out the links in the old process that can be improved.The emergency and first-aid information system was introduced in 2021,a"zero channel"treatment process was build for emergency and critical illness by the lean management concept and put into practice.The effect of the old process from January to December 2020 and the"zero channel"treatment process from January to December 2021 was compared through case review.Results The rescue success rates of emergency patients before and after the implementation of the"zero channel"treatment process were 95.78%and 98.26%,respectively.The"zero channel"treatment process significantly improved the rescue success rate of emergency and critical illness(P<0.05).The operation rate of acute trauma patients within the"golden 1 hour"was 84.84%,the average admission to CT completion time was(12.06±1.96)min,the average admission to operation start time was(27.51±4.52)min,the average time of emergency surgery for chest pain patients was(64.99±6.26)min,and the mean time of thrombolysis in stroke patients was(45.28±6.95)min,and all the data were significantly decreased compared with those before zero-channel implementation(P<0.05).Conclusions The"zero-channel"treatment process of emergency and critical illness based on the emergency and first-aid information system can shorten the waiting time in each emergency link,reduce waste,improve emergency efficiency,and ensure patient safety,win the"golden"time of patient rescue,and obtain better first-aid benefits and patient satisfaction.