基于加速康复外科-多学科团队构架下建立的All in One病房工作模式探索  

The working mode of All in One ward established under the framework of ERAS-MDT

作　　者：雷泽华[1] 赵欣 谢青云[1] 杨洁[1] 龚杰 蒋康怡 高峰畏 薛谦 李凡敏 王利[3] Lei Zehua;Zhao Xin;Xie Qingyun;Yang Jie;Gong Jie;Jiang Kangyi;Gao Fengwei;Xue Qian;Li Fanmin;Wang Li(Department of Hepatobiliary and Pancreatic Surgery,the People's Hospital of Leshan,Leshan 614000,Sichuan,China;General Medical Department,the People's Hospital of Leshan,Leshan 614000,Sichuan,China;Geriatric Department,the People's Hospital of Leshan,Leshan 614000,Sichuan,China)

机构地区：[1]乐山市人民医院肝胆胰外科,四川乐山614000 [2]乐山市人民医院全科医疗科,四川乐山614000 [3]乐山市人民医院老年医学科,四川乐山614000

出　　处：《加速康复外科杂志》2023年第2期64-70,共7页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

基　　金：四川省卫生健康委科研课题(普及应用项目)(20PJ296);乐山市2022年重点科技计划项目(22SZD072)。

摘　　要：基于多学科团队(multi-disciplinary team,MDT)参与的加速康复外科(enhanced recovery after surgery,ERAS)(ERAS-MDT)构架下建立的All in One(AO)病房,通过外科联合具有综合属性的内科协助外科治疗作为AO病房的主体病房,纳入在专业治疗上需要进行深度介入干预的相应专业组成的辅助病房以及协助外科完成治疗工作的相关专业组成的支持治疗病房,组成综合性独立单元体,其目标是探索多学科协同促进外科患者围手术期加速康复的策略。通过在加速康复AO病房实施LEER模式工作流程(即“少痛”“早动”“早食”“安心”)来实现患者术后加速康复这一共同目标。通过AO病房的治疗,期望增加老年、危重症患者的手术率,减少术后并发症的发生率,缩短外科患者平均住院时间,加快外科病房周转,节约有限的医疗资源,并拓展ERAS的应用领域。从形式和内容上创新了MDT,不仅有利于医院通过内部资源整合为外科纾困解难,也为进一步探索和深化慢病管理和临床专业协同工作模式提供了一种有益借鉴。The All in One(AO)ward established under the framework of ERAS-MDT serves as the main ward of the AO ward through surgery combined with internal medicine with comprehensive attributes to assist surgical treatment,including auxiliary wards composed of corresponding specialties requiring deep intervention in professional treatment and comprehensive independent units composed of related specialties that usually assist surgery to complete the treatment.Its goal is to explore cooperation to promote the perioperative recovery of surgical patients.In order to achieve the common goal of enhanced recovery after surgery of patients,the common goal of accelerated rehabilitation of patients was achieved by jointly adopting the workflow of LEER mode,that is,“less pain”,“early move”,“early eat”,“reassuring”in the ERAS AO ward.By the treatment in AO ward,it is expected to increase the operation rate of elderly,critical patients,reduce the incidence of postoperative complications,shorten the average hospitalization days of surgical patients,speed up the turnover of surgical wards,save limited medical resources,expand the application field of ERAS,and innovate MDT in form and content,which is not only conducive to the integration of internal resources in the hospital for surgical relief.It also provides a useful reference for further exploring and deepening the cooperative work between chronic disease management and clinical specialties.

关 键 词：LEER模式 加速康复外科 多学科团队 All in One病房 

分 类 号：R197.323[医药卫生—卫生事业管理]