四色分級制度在急診患者候診管理中的應(yīng)用*

□ 包英群 BAO Ying-qun 吳莉莉 WU Li-li 高志宏 GAO Zhi-hong*

Objective To investigate and analyze the effect of four-color grading system in managing patients waiting in emergency department. Method A convenient sampling method was used to extract 1873 emergency patients using the four-color grading system as the observation group, and 1954 emergency patients using the ordinary grading system were selected as the control group. Patients' satisfaction with waiting and the waiting time of the emergency patients in the two groups were compared. Result The satisfaction of patients in the observation group was significantly higher than that in the control group, and the average waiting time of patients in the observation group was significantly lower than that in the control group (p＜ 0.05). Conclusion The application of the four-color grading system in the management of emergency patients can effectively reduce the waiting time and improve the satisfaction of patients with waiting for treatment, thus improving the order of hospital.

隨著現(xiàn)代急診醫(yī)學(xué)快速發(fā)展及患者對醫(yī)療衛(wèi)生需求的不斷增長，綜合醫(yī)院急診科過度擁擠[1-3]已經(jīng)成為全球普遍性的問題。擁擠的主要原因有：對病情嚴(yán)重程度認(rèn)識不清、認(rèn)為就診應(yīng)嚴(yán)格按照“先到先看”、不能準(zhǔn)確找到候診區(qū)域等等[4]。

正確的分診是為患者爭取救治時間、獲得救治的第一關(guān)[5]。現(xiàn)已有醫(yī)院開始采用不同分級標(biāo)準(zhǔn)進行分診處理，但患者對分診制度及候診區(qū)域概念模糊，分診效果不理想，診室門口擁擠。研究設(shè)計《四色分級制度》，是結(jié)合患者病情危重程度及患者心理的分級方法，通過在分診臺顯著位置標(biāo)注各級病情嚴(yán)重程度及候診區(qū)域顏色，有利于患者更容易找到自己的候診區(qū)域及對病情嚴(yán)重患者給予更多理解[6]。本文將《四色分級制度》應(yīng)用于急診科候診管理過程，通過分析患者候診時間及候診滿意度來驗證該方法對候診管理的效果。

對象與方法

1.對象。采用便利抽樣法，抽取2017年8月至9月到我院急診科就診的急診患者1873例為觀察組，2017年6月至7月到同一急診科就診的急診患者1954例為對照組。納入標(biāo)準(zhǔn)：(1)年齡＞14周歲；(2)因本次癥狀初次到本院就診。排除標(biāo)準(zhǔn)：自動離院者。知情同意，并自愿參加調(diào)查者。兩組患者性別、年齡、文化程度等基本資料見表1，組間比較，差異均無統(tǒng)計學(xué)意義(p＞0.05)，具有可比性。

表1 患者基本信息 [n(%)]

2.方法。觀察組患者采用《四色分級制度》進行分級分區(qū)候診，分級標(biāo)準(zhǔn)及候診區(qū)域見表2、表3。對照組患者采用普通分級法進行候診。……