某院术前多学科联合评估门诊的构建与实施  

Construction and implementation of preoperative multidisciplinary evaluation clinic in a certain hospital

作　　者：张良燕[1] 张路[2] 刘子嘉[1] 刘宇超[1] 曲璇 朱鸣雷 康琳 陈丽霞[2] 申乐[1] 黄宇光[1] Zhang Liangyan;Zhang Lu;Liu Zijia;Liu Yuchao;Qu Xuan;Zhu Minglei;Kang Lin;Chen Lixia;Shen Le;Huang Yuguang(Department of Anesthesiology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Rehabilitation Medicine,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China;Department of Gerontology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院麻醉科,北京100730 [2]中国医学科学院 北京协和医学院 北京协和医院康复医学科,北京100730 [3]中国医学科学院 北京协和医学院 北京协和医院老年医学科,北京100730

出　　处：《中华医院管理杂志》2024年第8期604-608,共5页Chinese Journal of Hospital Administration

基　　金：北京协和医院中央高水平医院临床科研专项(2022-PUMCH-B-007,2022-PUMCH-B-129)。

摘　　要：为改善老年患者和其他病情复杂患者术前多次就诊评估的现状,2022年12月,北京协和医院设立术前多学科联合评估门诊(以下简称联合门诊),通过组建多学科团队,明确服务对象以及制定标准化门诊工作流程,为患者提供"一站式"的术前评估(身体适能评估、营养评估和衰弱评估等)、营养优化干预以及预康复宣教和指导等服务,强化术前风险管理,提升了术前评估效率,保障了围术期患者安全。截至2023年9月,联合门诊累计接诊患者128例,其中86例经术前评估与预康复优化后接受了手术,其肥胖率、吸烟率和衰弱人数分别从就诊时的13.96%、11.63%和18例降至手术前1 d的9.30%、4.65%和14例,且术后恢复良好。该门诊改善了患者术前的身体状态,为高风险患者顺利接受手术创造了条件,取得良好成效,可为其他医院开展多学科协作的术前评估工作提供参考。To improve the current situation of multiple preoperative visits and evaluations for elderly patients and other patients with complex conditions,in December 2022,Peking Union Medical College Hospital established preoperative multidisciplinary evaluation clinic(shorted as joint clinic).The joint clinic established a multidisciplinary team,clarified service targets,and developed standardized clinic workflows to provide patients with a"one-stop"preoperative assessment(physical fitness assessment,nutritional assessment,and frailty assessment,etc.),nutritional optimization intervention,and prerehabilitation education and guidance services.This practice strengthened preoperative risk management,improved preoperative assessment efficiency,and ensured the safety of patients during the perioperative period.As of September 2023,the joint clinic had received a total of 128 patients,of which 86 underwent surgery after preoperative evaluation and prehabilitation optimization.The obesity rate,smoking rate,and number of frailty cases of these patients had decreased from 13.96%,11.63%,and 18 at the time of visit to 9.30%,4.65%,and 14 on the day before surgery,respectively.They had recovered well after surgery.This practice had improved the preoperative status of patients and created conditions for high-risk patients to undergo surgery smoothly,so as to provide references for other hospitals to carry out multidisciplinary collaborative preoperative evaluation works.

关 键 词：多学科 联合门诊 术前评估 老年患者 预康复 

分 类 号：R197.32[医药卫生—卫生事业管理]