医院闭环管理情境下血液透析备援联合体实践  

Practice of a hemodialysis alliance in the context of closed-loop hospital management

作　　者：钱璟 王梦婧 陆楚涵 程平 倪丽 刘威[3] 黄碧红 叶志斌 严震文 程倩秋 余晨[6] 王爱丽[7] 彭艾[8] 徐巍 陆春来 陈丹丹 于秀峙 费利燕 马骏[14] 沈佳岚 李军辉 李颖[17] 陈凌云 吴伟峰 俞荣强 许丽华 陈靖 Qian Jing;Wang Mengjing;Lu Chuhan;Cheng Ping;Ni Li;Liu Wei;Huang Bihong;Ye Zhibin;Yan Zhenwen;Cheng Qianqiu;Yu Chen;Wang Aili;Peng Ai;Xu Wei;Lu Chunlai;Chen Dandan;Yu Xiuzhi;Fei Liyan;Ma Jun;Shen Jialan;Li Junhui;Li Ying;Chen Lingyun;Wu Weifeng;Yu Rongqiang;Xu Lihua;Chen Jing(Department of Nephropathy,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Nursing,Huashan Hospital,Fudan University,Shanghai 200040,China;National Clinical Research Center of Aging and Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Nephrology,Huadong Hospital,Fudan University,Shanghai 200040,China;Department of Nursing,Huadong Hospital,Fudan University,Shanghai 200040,China;Department of Nephrology,Tongji Hospital of Tongji University,Shanghai 200065,China;Department of Nursing,Tongji Hospital of Tongji University,Shanghai 200065,China;Department of Nephrology and Rheumatology,Tenth People′s Hospital of Tongji University,Shanghai 200072,China;Department of Nursing,Tenth People′s Hospital of Tongji University,Shanghai 200072,China;Department of Nephrology,905th Hospital of PLA NAVY,Shanghai 200052,China;Department of Nursing,905th Hospital of PLA NAVY,Shanghai 200052,China;Department of Nephrology,PLA Navy Medical Center,Shanghai 200052,China;Department of Nursing,PLA Navy Medical Center,Shanghai 200052,China;Department of Nephrology,Jing′an District Central Hospital,Shanghai 200040,China;Department of Nursing,Jing′an District Central Hospital,Shanghai 200040,China;Department of Nephrology,Putuo District People′s Hospital,Shanghai 200060,China;Department of Nursing,Putuo District People′s Hospital,Shanghai 200060,China;Department of Nephrology,Shanghai Electric Power Hospital,Shanghai 200050,China;Department of Nursing,Shanghai Electric Power Hospital,Shanghai 200040,China;Department of Nephrology,Shanghai Post and Telecommunications Hospital,Shanghai 200050,China;Department of Nursing,Shanghai Post and Telecommunications Hospital,Shanghai 200040,China)

机构地区：[1]复旦大学附属华山医院肾病科,上海200040 [2]复旦大学附属华山医院护理部,上海200040 [3]复旦大学附属华山医院国家老年疾病临床医学研究中心,上海200040 [4]复旦大学附属华东医院肾内科,上海200040 [5]复旦大学附属华东医院护理部,上海200040 [6]同济大学附属同济医院肾内科,上海200065 [7]同济大学附属同济医院护理部,上海200065 [8]同济大学附属上海市第十人民医院肾病免疫科,上海200072 [9]同济大学附属上海市第十人民医院护理部,上海200072 [10]解放军海军第九〇五医院肾病科,上海200052 [11]解放军海军第九〇五医院护理部,上海200052 [12]解放军海军特色医学中心肾内科,上海200052 [13]解放军海军特色医学中心护理部,上海200052 [14]上海市静安区中心医院肾内科,上海200040 [15]上海市静安区中心医院护理部,上海200040 [16]上海市普陀区人民医院肾脏内科,上海200060 [17]上海市普陀区人民医院护理部,上海200060 [18]上海电力医院肾脏内科,上海200050 [19]上海电力医院护理部,上海200050 [20]上海邮电医院肾内科,上海200040 [21]上海邮电医院护理部,上海200040

出　　处：《中华医院管理杂志》2022年第8期595-599,共5页Chinese Journal of Hospital Administration

基　　金：上海市医学领军人才计划(2019LJ03)。

摘　　要：医院闭环管理是应对新型冠状病毒肺炎疫情的有效措施。2021年1月,为保障闭环管理下血液透析患者治疗服务的持续性,最大限度减少可能的医疗风险和感染风险,复旦大学附属华山医院联合上海市9家医院的血液透析中心组建血液透析备援联合体(以下简称联合体)。联合体通过提前准备场地、物资和人员班次以及建立管理制度和工作流程等举措,统筹优化区域内血液透析资源,确保当联合体中某些血液透析中心进入闭环管理时,透析患者能够快速有序分流到其他血液透析中心,按时进行高质量的血液透析治疗。2021年11月至2022年4月,联合体内部1459例血液透析患者有317例接受分流治疗,累计治疗1215例次,均无明显不良反应,取得良好成效。该实践可为重大公共卫生事件背景下医院快速建立互助模式提供参考。Closed-loop hospital management can effectivly cope with the COVID-19 pandemic.In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks,Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites,materials and personnel shifts in advance,and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services,in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022,317 of 1459 hemodialysis patients in the alliance were diverted to other centers for treatment,accumulating 1215 times/cases of treatments without obvious adverse reactions.The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

关 键 词：血液透析 联合体 闭环管理 新型冠状病毒肺炎 

分 类 号：R197.32[医药卫生—卫生事业管理]