| 摘要: |
| 患者流程数据能真实反映患者在医疗流程中的转移路径及效率，从而帮助设计者从患者的角度厘清医疗流程各环节在医疗空间上的状态与关系，为医疗建筑的设计提供真实可靠的前期资料。本文以重庆市西南医院老年医学科门诊为研究对象，运用流程挖掘法提取了患者高频诊疗流程，并分析概括出相关空间节点间的关联度。然后在此基础上，通过对患者转移路径的分析与比较，从科室定位与功能配置的角度提出了3种流线优化模式。最后为解决老年多病患者诊疗流线问题，提出“老年医学诊疗中心”概念，并结合调研数据对其内部的功能配置与布局进行了初步探索。 |
| 关键词: 患者流线 流程挖掘 适老化 老年医学科 诊疗中心 |
| DOI： |
| 分类号:TU246 |
| 基金项目: |
|
| Research on aging-friendly of patient flow in geriatrics department of a large general hospital based on process mining |
|
Wang Qi, Du Miao
|
| Abstract: |
| Objectives: In recent years, with the intensification of aging and the improvement of public health awareness, the demand for medical care for the elderly has increased dramatically, and the aging of medical buildings has become a key problem, especially the complex diagnosis and treatment process of large general hospitals very unfriendly towards older patients and the various problems with finding the way have meant that overall diagnostic and treatment efficiency is low. Patient flow data can truly reflect the transmission path of patients in the medical process, help designers clarify the state and relationship between the different parts of the medical process from the patient’s perspective in the medical space and time, and provide real information and reliable prior information for the Planning of hospital buildings. Therefore, this article aims to take the geriatric department of The Southwest Hospital of Amu in Chongqing as the research object and the actual diagnosis and treatment process of patients as the starting point to study the aging problem of the influx of elderly patients in large general hospitals.
Methods: Using field research,?we?first gather actual data on?the diagnosis and treatment?processes of elderly patients. We then?process?the?data?using?the process mining?program DISCO, eliminating?low-frequency activities and?pathways to create a?high-frequency model of the patients' diagnosis and?treatments,?and?summarizing?and?analyzing?the close?relationships?between the?pertinent process nodes. Next,?we record the number of spatial transfers of?elderly?patients and the transit distance under the current layout, which is?subsequently?used as a comparison?standard, and we simulate?the?real patient transfer path by combining it with Southwest Hospital's planar?spatial?relationship. We?then?investigated?the optimization of the three department positioning and function configuration modes compared with the original?mode, based on the high-frequency diagnosis and treatment process, the close relationship between the relevant spatial nodes, and the number of spatial transfers and transit distance as a comparison measure.
Results: (1) The geriatric department is mainly divided into two groups of high-frequency processes: First, the main processes for patients who do not need to undergo medical examination are “Registration (manual window)/Registration (electronic) - Primary waiting - Secondary waiting - Treatment - Manual window payment - Getting drug", and secondly, the main process for patients who need to undergo medical examinations is as follows: "Registration (electronic) / Registration (manual) - Primary waiting - Secondary waiting - Treatment - Manual Window Payment/Electronic Payment - Laboratory department - Electrocardiogram - Ultrasound - Radiology (in no particular order) - Receiving Report - Manual Window Registration - Primary Waiting - Secondary Waiting - Treatment - Manual window payment/Electronic Payment - Getting drug. (2) The frequency of medical technology is “Laboratory department - Electrocardiogram - Radiology - Ultrasound”in descending order. (3) 5 flow optimization modes: ①Functional configuration (clinic + waiting room) + Department positioning (near the registration and payment area and the electrocardiogram area); ②Functional configuration (clinic + waiting room + exclusive registration and payment) + Department positioning (close to the laboratory); ③Functional configuration (clinic + waiting room + exclusive registration and payment + electrocardiogram) + Department positioning (near the laboratory); ④Functional configuration (clinic + waiting room + exclusive registration and payment + ultrasound) + Department positioning (near the laboratory); ⑤Functional configuration (clinic + waiting room + exclusive registration and payment + electrocardiogram + ultrasound) + Department positioning (near the laboratory). (4) Functional configuration and design of the Geriatrics Treatment Center. Based on the special outpatient clinic of the geriatrics department, four affiliated clinics for cardiology, endocrinology, respiratory medicine and ophthalmology were established to ensure coordinated treatment with the geriatrics department. In addition, registration and payment, exclusive medical technology, a comprehensive examination room and a common MDT consultation area were added to provide more comprehensive and convenient medical services to geriatric patients with multiple diseases.
Conclusions: Using The Southwest Hospital of Amu as an example, this article demonstrates?the process mining?method's enormous potential?for?improving?patient flow in?the geriatric population. In order to give?geriatrics?accurate and trustworthy information about department positioning and functional configuration design, process mining analysis?of the patient flow in the?specialty?can?assist?designers?in highlighting?high-frequency diagnosis and treatment processes from the actual diagnosis and treatment activities of?patients. It can also help to?clarify the transmission relationship and frequency characteristics between geriatrics and other related departments additional functional?spaces. |
| Key words: Patient Flow Process Mining Aging-Friendly Geriatrics Treatment Center |
