应用价值流分析优化跨院区急性缺血性脑卒中患者诊疗流程的实践与探讨  

Practice of Optimizing Cross-Hospital Diagnosis-treatment Process of Acute Ischemic Stroke Patients by Value Stream Analysis

作　　者：陈鹏[1,2] 杨鹏 李萍[1,2] 陈姬雅 杨性托[3] 陈金华 蔡凌江[3] 余玲丽 江毅卿 王仙伟 郑邓飞 CHEN Peng;YANG Peng;LI Ping;CHEN Ji-ya;YANG Xing-tuo;CHEN Jin-hua;CAI Ling-jiang;YU Ling-li;JIANG Yi-qing;WANG Xian-wei;ZHENG Deng-fei(Taizhou Hospital of Zhejiang Province;Enze Hospital,Taizhou Enze Medical Central(Group);Wenling Orient Hospital)

机构地区：[1]浙江省台州医院 [2]台州恩泽医疗中心 [3]温岭东方医院

出　　处：《医院管理论坛》2022年第5期47-50,共4页Hospital Management Forum

基　　金：浙江省医药卫生项目,编号:2017KY705;台州市科技局项目,编号:1701KY15、20ywb111。

摘　　要：目的优化跨院区急诊缺血性脑卒中静脉溶栓及血管内治疗流程,改善患者预后。方法基于价值流对医联体跨院区急性缺血性脑卒中静脉溶栓及血管内治疗进行优化,评估临床效果。结果2019年6月至2021年6月,恩泽医院与东方医院完成跨院区转运静脉溶栓及血管内治疗患者62例。通过优化,患者到东方医院急诊至恩泽医院静脉溶栓时间(DNT)由98.45±6.65分钟缩短至55.13±5.75分钟,预后良好率由15.67%提高至52.12%。结论优化后的跨院区急性缺血性脑卒中诊治流程缩短了DNT,并改善预后。Objective To optimize the process of intravenous thrombolysis and intravascular treatment for acute ischemic stroke(AIS)across hospitals,so as to improve the prognosis of the patients.Methods Based on the value stream,the intravenous thrombolysis and intravascular treatment of AIS across hospitals within the medical alliance was optimized,and the clinical effect was evaluated.Results From June,2019 to June,2021,Enze Hospital and Orient Hospital completed 62 cases of cross-hospital intravenous thrombolysis and endovascular treatment.After the optimization,the time from arrival at emergency department in Orient Hospital to intravenous thrombolysis in Enze Hospital(DNT)was shortened from 98.45±6.65mins to 55.13±5.75mins,the rate of favourable prognosis was increased from 15.67%to 52.12%.Conclusion The optimized AIS diagnosis-treatment process across hospitals can obviously shorten DNT and improve the prognosis of patients.

关 键 词：价值流 医联体 急性缺血性脑卒中 静脉溶栓 

分 类 号：R197.3[医药卫生—卫生事业管理]