摘要
目的 探讨主诊医师负责制在胸痛中心运行的实施成效,为胸痛中心的持续优化和管理提供理论依据和实践指导。方法 以胸痛中心院内流程为切入点,试运行主诊医师负责制。明确由心血管内科中心主任牵头负责,成立胸痛门诊组、普通病房主诊组和CCU主诊组,并绩效考核到各主诊组。运用SPSS28.0软件进行统计学分析,比较胸痛中心2022年10月1日—2023年7月31日实施主诊医师制前与2023年10月1日—2024年7月31日实施主诊医师制后的数据差异及变化趋势。结果 经过试运行后从中国胸痛中心数据平台提取到7155样本数据量包含患者的例数、急诊PCI例数、D2W时间平均值、ACS患者随访率,医院卫生统计系统提取的2049样本数据量包含急性心肌梗塞病种例数、平均住院日、死亡率。实施主诊医师负责制后,胸痛患者上报例数从745例增加到6410例,急诊PCI例数从349例增加到400例,D2W时间平均值从74.11分钟下降到68.97分钟,且实施前后患者数量、急诊PCI例数、D2W时间平均数上的差异均有统计学意义;ACS患者1月随访率从10.36%提升到80.30%,3月随访率从22.20%提升升到59.44%,且实施前后的1随访率、3月随访率的差异均有统计学意义。结论 推行主诊医师负责制,对胸痛中心产生了积极影响:增加了胸痛中心的数据填报、提高了胸痛中心的运行效率、提高了患者1月与3月随访率、促进了胸痛中心的建设和发展。
Objectives This study aims to explore the implementation effect of the attending physician responsibility system in the operation of the chest pain center,with the aim of providing theoretical basis and practical guidance for the continuous optimization and management of the chest pain center.Methods Taking the in-hospital chest pain center process as the starting point,a pilot implementation of the attending physician responsibility system was conducted.It was clearly stipulated that the director of the cardiovascular internal medicine center would take the lead and be responsible,and the chest pain outpatient group,the general ward chief physician group,and the CCU chief physician group were established,with performance evaluations conducted for each chief physician group.SPSS 28.O software was used for statistical analysis.The data differences and changing trends before the implementation of the attending physician system in the chest pain center from October 1,2022 to July 31,2023 and after the implementation of the attending physician system from October 1,2023 to July 31,2024 were compared.Results Following the trial operation,7,i55 sample data points were extracted from China's Chest Pain Center data platform,including the number of patient cases,emergency PCI procedures,D2W time,and follow-up rates for ACS patients.Additionally,2,049 sample data points were obtained from the hospital's health statistics system,containing statistics on acute myocardial infarction cases,average hospital stays,and mortality rates.After the implementation of the chief physician responsibility system,the number of reported chest pain patients increased from 745 to 6,410,the number of emergency PCI cases increased from 349 to 400,the average D2W time decreased from 74.106 minutes to 68.9702 minutes,moreover the differences in the number of patients,the number of emergency PCI cases,and the average D2W time before and after the implementation were all statistically significant;the 1-month follow-up rate of ACS patients increased from 10.36%to 80.30%,and the 3-month follow-up rate increased from 22.20%to 59.44%,and the differences in the 1-month follow-up rate and the 3-month follow-up rate before and after the implementation were also statistically significant.Conclusions The implementation of the attending physician responsibility system has had a positive impact on the chest pain center:it has increased the data reporting of the chest pain center,improved the operating efficiency of the chest pain center,increased the patient follow-up rate at 1 and 3 months,and promoted the construction and development of the chest pain center.
作者
陈世景
翟光耀
蔡大伟
齐疏影
赵新月
冀杨
陈学明
Chen Shijing;Zhai Guangyao;Cai Dawei;Qi Shuying;Zhao Xinyue;Ji Yang;Chen Xueming(Beijing Luhe Hospital,Capital Medical University,Beijing 101100,China)
出处
《中国病案》
2025年第9期23-26,共4页
Chinese Medical Record
基金
北京市通州区科委发展科研储备项目(KJ2023CX019)。
关键词
主诊医师负责制
胸痛中心
效果
Chief physician responsibility system
Chest Pain Center
Achievements
