Abstract：
Ambulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised. A two-phase strategic quality improvement project was implemented at the authors\' acute trust. Ambulance handover data from between 2 November 2020 and 26 July 2021 provided a benchmark for the project. The first phase was implemented between 2 November 2021 and 26 July 2022 and aimed to reduce 60-minute ambulance handover delays. The second phase was implemented between 2 November 2022 and 26 July 2023 and aimed to eradicate 60-minute ambulance handover delays and improve overall performance. Phase one resulted in a 32% reduction in 60-minute ambulance handover delays. Phase two resulted in a 97% reduction in 60-minute ambulance handover delays. Over the course of the project there was a 24% increase in handovers completed within 15 minutes. This project demonstrates how strategic planning and collaboration between healthcare teams can reduce the potential for avoidable patient harm, while simultaneously promoting workforce well-being and retention.
摘要：
当急诊部门变得人满为患时，救护车移交延迟出现，因为等待长时间入院的患者占据了旨在促进急诊到达的评估和治疗的临床隔间。作为回应,许多组织开始依赖暂时收容严重不适的病人，等待在走廊等未指定的区域接受护理，提供额外的空间。这导致了可避免伤害的重大风险，对患者的侮辱和心理创伤，并对医疗保健专业人员的福祉产生负面影响，因为不可接受的护理标准变得正常化。在作者的高度信任下实施了一个两阶段的战略质量改进项目。2020年11月2日至2021年7月26日的救护车交接数据为该项目的基准。第一阶段于2021年11月2日至2022年7月26日实施，旨在减少60分钟的救护车交接延误。第二阶段于2022年11月2日至2023年7月26日实施，旨在消除60分钟的救护车交接延误并提高整体性能。第一阶段使60分钟的救护车交接延迟减少了32％。第二阶段使60分钟的救护车交接延迟减少了97％。在项目过程中，在15分钟内完成的移交量增加了24％。该项目展示了医疗保健团队之间的战略规划和协作如何减少可避免的患者伤害的可能性。同时促进劳动力福祉和保留。
