The ageing of the population, the increase in chronic degenerative diseases and the recent remodeling of hospital beds, rehabilitation and long-term post-acuity make elderly people frequent users of the emergency room, with inevitable overcrowding due to boarding, that is to the parking for hours at the ER waiting for the bed. The objective of the study is to highlight how the adoption of a bed management system can positively affect the management of overcrowding in First Aid and contain the phenomenon of boarding, providing any organizational suggestions in order to improve patient flow. The data show that the average age of patients requiring hospitalization from the ER is 64 years with increasing attendance of over eighty years. 18% of admissions are in internal medicine, followed by 8% in neurology clinic and 6% in medical and orthopaedic clinic. The overall average time taken over is lower than the reference times for all triage codes. The average total waiting time for hospitalization is almost 7 hours (6 hours and 55 minutes) with peaks of about 90 hours for hospitalization in Internal Medicine. Reports of adverse events and complaints to the Public Relations Office were also analysed. Improving the operational efficiency of first aid in the current epidemiological context requires hospital-level changes to address bottlenecks downstream of care, using new care models such as the implementation of a nursing management discharge unit, where low-intensity patients are temporarily concentrated on waiting for discharge, transfer or return to the institutions of origin and a strengthening of relations with territorial realities. Key words: overcrowding, boarding, bed management, discharge unit.
L'invecchiamento della popolazione , l'aumentare di malattie cronico-degenerative e la recente rimodulazione dei posti letto ospedalieri , di riabilitazione e di lungodegenza post-acuzie rendono gli anziani utenti frequenti del pronto soccorso, con inevitabile sovraffollamento dovuto al boarding, ovvero allo stazionamento per ore al Pronto Soccorso in attesa del posto letto. L’obiettivo dello studio è quello di evidenziare come l’adozione di un sistema di Bed management possa influire positivamente sulla gestione del sovraffollamento in Pronto Soccorso e contenere il fenomeno del boarding, fornendo eventuali suggerimenti organizzativi al fine di migliorare il patient flow. I dati mostrano che l’età media dei pazienti che richiedono il ricovero dal Pronto Soccorso è di 64 anni con sempre maggiore affluenza di ultraottantenni. Il 18% dei ricoveri afferiscono in Medicina interna, seguiti dall’8% in clinica di Neurologia e il 6% in Clinica Medica e Ortopedia. Il tempo medio complessivo di presa in carico risulta inferiore ai tempi di riferimento per tutti i codici triage. Il tempio medio complessivo di attesa per il ricovero risulta essere di quasi 7 ore (6 ore e 55 minuti) con punte di circa 90 ore per i ricoveri in Medicina Interna. Sono stati analizzati anche le segnalazioni di eventi avversi e reclami all’Ufficio Relazioni con il Pubblico. Un miglioramento dell'efficienza operativa del pronto soccorso nell'attuale contesto epidemiologico richiede modifiche a livello ospedaliero che affrontino i colli di bottiglia a valle dell'assistenza, utilizzando nuovi modelli di assistenza come l’implementazione di una discharge unit a gestione infermieristica, dove concentrare temporaneamente pazienti a bassa intensità di cure in attesa di dimissione, trasferimento o ritorno presso le istituzioni di provenienza e un rafforzamento delle relazioni con le realtà Territoriali. Key words: overcrowding, boarding, bed management, discharge unit.
Impatto dell’introduzione del Bed Manager Operativo in un DEA di II livello: uno studio osservazionale retrospettivo monocentrico.
MENGONI, DONATELLA
2020/2021
Abstract
The ageing of the population, the increase in chronic degenerative diseases and the recent remodeling of hospital beds, rehabilitation and long-term post-acuity make elderly people frequent users of the emergency room, with inevitable overcrowding due to boarding, that is to the parking for hours at the ER waiting for the bed. The objective of the study is to highlight how the adoption of a bed management system can positively affect the management of overcrowding in First Aid and contain the phenomenon of boarding, providing any organizational suggestions in order to improve patient flow. The data show that the average age of patients requiring hospitalization from the ER is 64 years with increasing attendance of over eighty years. 18% of admissions are in internal medicine, followed by 8% in neurology clinic and 6% in medical and orthopaedic clinic. The overall average time taken over is lower than the reference times for all triage codes. The average total waiting time for hospitalization is almost 7 hours (6 hours and 55 minutes) with peaks of about 90 hours for hospitalization in Internal Medicine. Reports of adverse events and complaints to the Public Relations Office were also analysed. Improving the operational efficiency of first aid in the current epidemiological context requires hospital-level changes to address bottlenecks downstream of care, using new care models such as the implementation of a nursing management discharge unit, where low-intensity patients are temporarily concentrated on waiting for discharge, transfer or return to the institutions of origin and a strengthening of relations with territorial realities. Key words: overcrowding, boarding, bed management, discharge unit.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12075/1203