PT -期刊文章盟劳拉·斯坦AU -安娜步伐盟Mandip Dhamoon AU -斯蒂芬Krieger TI -了解居民工作流和教育经验来实现先进实践临床医生在神经病学实习培训项目(P1.011) DP - 2018年4月10 TA -神经病学PG - P1.011 VI - 90 IP - 15补充4099 - //www.ez-admanager.com/content/90/15_Supplemen首页t/P1.011.short 4100 - //www.ez-admanager.com/content/90/15_Supplement/P1.011.full所以Neurology2018 4月10;90 AB -目的:1。评估工作流在三级转诊神经病学实习项目2。首页结合先进的实践临床医生(APC)患者安全的解决问题和居民教育服务的平衡。背景:神经病学的倦怠率最首页高的国家之一,并增加病人量会导致人格解体的感觉以及对工作的不满意。在我们的机构、中风服务排放从2010 - 2015年增加了71%,从2014 - 2015咨询量增加了24%。与此同时,居民没有增加补充或雇佣更多的员工。设计/方法:我们调查现任和前任居民感知的病人数量,教育经验,充足的人力资源,和病人安全。我们跟踪咨询的时间来更好地评估工作流中的模式超过一个月。根据调查结果,我们提出招聘4个APC来满足未满足的工作流和教育需求。Results: Clinical volume was highest between 12 and 10 pm, which included a five-hour stretch with only one resident is in house. Although short call from 5–8pm is required for compliance with ACGME duty hour regulations, residents agreed that this yields inefficiencies, with simultaneous requirements for two rounds of handoff while fielding new consults and managing inpatient issues. Residents felt they needed assistance with tasks related to medication reconciliation, obtaining outside records, and preparing discharges before noon. They also felt patient safety was at risk for being compromised during handoff periods and after 8 pm on weekdays and 4 pm on weekends. Based on these results, we hired four APC to work staggered shifts from 7-4:30 pm and 12-8:30 pm seven days per week. Additionally, we designed APC roles around tasks deemed less educational for residents, including medication reconciliation and preparing discharges before noon.Conclusions: Understanding resident workflow and educational experience allows for implementation of an APC program that can optimize patient safety and resident education.Disclosure: Dr. Stein has nothing to disclose. Dr. Pace has nothing to disclose. Dr. Dhamoon has nothing to disclose. Dr. Krieger has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with acorda, bayer, biogen, emd serono, genentech, genzyme, mallinckrodt, medday, novartis, teva, and tg therapeutics .
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