基于多学科共建病房的医疗管理模式探索  

Exploration of Medical Management Mode Based on Multi-disciplinary Co-construction of Wards

作　　者：于玥 李卫红[1] Yu Yue;Li Weihong(Beijing Tongren Hospital Affiliated to Capital Medical University,Beijing 100730,China;不详)

机构地区：[1]首都医科大学附属北京同仁医院,北京市100730

出　　处：《中国病案》2025年第2期30-34,共5页Chinese Medical Record

摘　　要：目的 基于多学科共建病房的医疗管理模式探索,以实现全院一张床的管理,最终以提升病床利用效率以及重大疾病的综合诊治能力为目的。方法 选取某医院2022年1月1日-2023年12月31日所有在甲状腺头颈外科及胸外科住院的所有患者。以2022年1月1日-12月31日的所有患者及病床数为对照组;以2023年1月1日-12月31日的所有患者和病床数为实验组。对照组中甲状腺头颈科和胸外科均有51张床,各病房仅收治本科患者;实验组2023年胸外科将6张床位供甲状腺头颈外科共同使用,其剩余45张床位收治本科患者。采取构建分级分层管理体系,创新系统化高效管理模式,规范病历内涵质量,优化绩效考核方案为方法,有效提升全院病床的整体利用。结果 在共建病房的管理模式下,甲状腺头颈外科入院前等候时间从平均23.01±3.26天,缩短为18.1±4.18天;四级手术从2022年631例,增加到2023年的1184例,净增加553例,住院费用减少,差异均有统计学意义,手术量均增加(P<0.05);胸外科入院前等候时间平均从4.96±2.71天,增加为8.96±3.83天。四级手术从2022年506例,增加到2023年的979例,净增加473例,住院费用减少,差异均有统计学意义(P<0.05)。出院患者平均住院日两科在2023年全年出院患者平均住院日较2022年同期缩短0.86天左右。甲状腺头颈外科在2022年床位使用率45/51(88.23%),2023年增长到50/51(98.04%),差异有统计学意义(P<0.05)。胸外科病房在2022年51张床仅使用43张,床位使用率即84.31%,2023年将6张床位用于和甲状腺头颈共建,科室剩45张床位,但共建的6张全部住满,全年病床使用率增长为51/45(111.11%),较2022年同期增加26.69%,差异均有统计学意义(P<0.05)。结论 通过多学科共建病房,实现全院一张床,有效提升全院病床的整体利用及重大疾病的综合诊治能力,为医院发展提供借鉴。Objectives To explore the medical management mode of multi-disciplinary co-construction wards,in order to realize the management of one bed in the whole hospital,and ultimately to improve the utilization efficiency of beds and the comprehensive diagnosis and treatment ability of major diseases.Methods From January 1st,2022 to December 31st,2023,all patients admitted to the department of thyroid head and neck surgery and thoracic surgery in a hospital were selected.All patients and beds from January 1st to December 31st,2022 were used as control group;All patients and beds from January 1st to December 31st,2023 were used as the experimental group.In the control group,there were 51 beds in the departments of thyroid head and neck and thoracic surgery,and only undergraduate patients were admitted in each ward.In the experimental group,6 beds in the department of thoracic surgery would be used jointly by the department of thyroid head and neck surgery in 2023,and the remaining 45 beds would be used for undergraduate patients.Adopting the methods of constructing hierarchical management system,innovating systematic and efficient management mode,standardizing the connotation quality of medical records,optimizing performance appraisal scheme,effectively improving the overall utilization of hospital beds.Results The waiting time before admission in the department of head and neck surgery was reduced from 23.01±3.26 days to 18.1±4.18 days.The number of level 4 operations increased from 631 in 2022 to 1184 in 2023,a net increase of 553 cases,the hospitalization cost decreased,the differences were statistically significant,and the operation volume increased(P<0.05).The average waiting time before admission in thoracic surgery increased from 4.96±2.71 days to 8.96±3.83 days.The number of level 4 operations increased from 506 in 2022 to 979 in 2023,a net increase of 473 cases,and the hospitalization cost decreased,with statistical significance(P<0.05).The average length of hospital stay of discharged patients in the two de

关 键 词：多学科 共建病房 疑难病例 医疗管理 

分 类 号：R197.3[医药卫生—卫生事业管理]