大型综合医院床位统一调配优化管理实践和成效  

Practice and effectiveness of unified allocation and optimization management of beds in large comprehensive hospitals

作　　者：李盈[1] 金雯[1] 张正宇 LI Ying;JIN Wen;ZHANG Zhengyu(The First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院,浙江杭州310003

出　　处：《现代医院》2023年第8期1230-1233,共4页Modern Hospitals

基　　金：浙江省医药卫生科技项目(2020KY561)。

摘　　要：目的在大型综合医院一院多区同质化管理模式下,为提高全院及科室运行效率、利用好空余床位、解决一床难求问题提供科学依据。方法打造一站式入院服务中心,开展床位统一调配管理,构建全周期智慧入院管理系统,收治打破“四大壁垒”,实现跨院区-跨内外科-跨专科-跨医疗组收治,结合患者病情轻重缓急,秉持“效率优先、安全至上、学科相近,地源相近”的原则搭建高效科学的收治体系,并结合DRGs指标动态调整优化科室的床位配置。结果医院和各院区床位运行效率逐年上升,平均住院时间和术前待床日逐年下降,CMI逐年稳步增长。运用Pabon Lason模型评价各科室的床位运行效率,2022年基本都高于2021年。结论在“全院一张床”模式下,通过高效合理的跨科收治体系可以高质量利用医疗资源,实现效率效益最大化,推动医院迈向高质量、“双一流”的发展赛道。Objective To provide a scientific basis for improving the operational efficiency of the entire hospital and departments,making good use of spare beds,and solving the problem of insufficient bed supply under the homogeneous management mode of multiple districts in a large comprehensive hospital.Methods A one-stop admission service center was established to carry out unified allocation and management of beds.A full-cycle intelligent admission management system was established to break the barriers between departments,regions,specialties and medical groups,and achieve cross-hospital area,cross-internal surgery,cross-specialty,and cross-medical group admission.An efficient and scientific admission system was established based on the principles of“efficiency the first,safety the first,combination of the similar disciplines,and integration of adjacent wards”.The beds were allocated by dynamical adjustment and optimization based on DRG indicators.Results The operational efficiency of bed allocations in our hospital and each department was increased year by year,while the average length of stay and days for preoperative bed occupation were decreased year by year.CMI was steadily increased year by year.The Pabon Lasso model was used to evaluate the bed operating efficiency of each department,showing that the operational efficiency of beds across all the departments in 2022 was higher than in 2021.Conclusion Under the concept of“one ward of beds for the whole hospital”,an efficient and reasonable interdisciplinary admission system can make high-quality use of medical resources and maximize efficiency and benefits,thus promoting the hospital to move towards a high-quality and“double first-class”development track.

关 键 词：跨科收治 全院一张床 床位利用率 病床周转次 pabon lasso 模型 

分 类 号：R197.32[医药卫生—卫生事业管理]