课件：icu与临床其它科室的有效协作及诊疗服务新进展.ppt

* * * * * * JCAHO ICU的标准 - 疾病严重性调整后的死亡率和住院时间 - 急性医生的使用 - 气管插管病人的体位改变 - DVT 静脉拴塞的预防和处理 - 应急性胃溃疡 - CRBI - 日常体位改变 eICU e-ICU的重症监护标准 The eICU? Solution e-ICU是确保急救成功的答案 - 包括远程的、中央控制的、重症治疗水平的治疗团队 - 使用先进的电子化技术进行不间断的监测、评估和现时现场急救治疗 - 通过信息化技术手段改变治疗的方式 VISICU的历史 Founded in 1998 Two Johns Hopkins Intensivists Located in Baltimore’s “Digital Harbor” Customer base e-ICU的医院布局 e-ICU的优势 “- 通过减少治疗的复杂性，有效挽救病人的生命 ” Clinical Action Real-time data eICU? “Reducing the interval from the time data is available until the time it is used for decision-making drives significant and often unexpected improvements in care.” Gary Yates, M.D. VP of Quality Sentara Healthcare e-ICU 的图示，成本控制和质量管理等议题 Distributed eICU? Coverage Model Central Hospital East Hospital West Hospital Physician’s Home (Specialist) Physician’s Office (Specialist) eICU? Facility Tertiary Hospital Center LAN Internet VPN Key Specialist Care (Night) Specialist Care (Day) Routine eICU Care eICU Workstation eCareManager The Source Smart AlertsTM Smart ReportsTM eVantage? Technology Tools 监测血压、血氧、通气等生命体征 - 临界值和趋势控制 - 病人的特殊处理 ? 化验结果和用药 - 趋势的分析和综合因素 - 数据收集 - 逻辑推断 e-ICU 安全指标 ICU 的成本分析 eLert? Emergency Button ICU 的成本分析 Value=Quality/Cost ICU Demand Increasing Source: The Advisory Board High ICU Costs ICU Outliers Outlier: ICU LOS 6 days % eICU? Solution Results* Critical Care Medicine 32:31-38;2004 -27% -17% -13% * Severity Adjusted Outlier Reduction-The Target -17% -30% -28% -5% Percent Outliers Outlier LOS ICU 的成本分析 Annualized Data Norfolk General (18 beds) “Health care has safety and quality problems because it relies on outmoded systems of work. If we want safer, higher-quality care, we will need to have redesigned systems of care”. The Institute of Medicine Report Crossing the Quality Chasm, 2001 IOM: Care Must Be Process Driven ICU redesign has the highest yield Omnipresent Focused Evidence-based Real-time Integrated Distributed Pro-active Continuous Coordinated 技术支持 EXPERTISE INFOR