The Rapid Conversion of Ordinary Recovery Beds to an Overnight Intensive Recovery (OIR) to Alleviate the High Pressure on Postoperative Intensive Care Demands During COVID-19 Pandemics in a Local Tertiary Hospital: a Multi-perspective Value-based Analysis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 299
- 试验地点
- 1
- 主要终点
- total number of ICU bed days spared
研究概览
简要总结
To evaluate the value-based effectiveness of the implementation of TMH Extended post anaesthetic care in PACU during COVID-19 pandemics by an institutional matched case-control and quantitative survey study Two ordinary recovery beds were converted to an overnight intensive recovery ("Extended post-anesthetic care in PACU") within the operating theatre complex of Tuen Mun Hospital during COVID-19 pandemics, in an attempt to free the ICU bed and resources from postoperative patients. This study was designed to evaluate the efficacy and staff perceptions towards the abrupt implementation of TMH extended post-anesthetic care in PACU by mobilization of the existing OT resources to cope with the COVID-19 emergency situations. The value-based analysis would look into the implementation effectiveness in twofold: 1) the clinical efficacy using a case-control audit on clinical outcomes and 2) the staff acceptance by means of the staff attitudes survey. Hopefully, this would provide a multi-perspective evaluation of the implementation strategies and aid planning of new services in the future.
详细描述
2 parts are included in this study
The Matched Case-Control study, with the aim of analyzing the clinical efficacy of TMH Extended post-anesthetic care in PACU during COVID-19 in a value-based healthcare model. We included all postoperative patients admitted in TMH Extended post-anesthetic care in PACU during COVID epidemics, excluding patients awaiting ICU in the ordinary recovery room or patients requiring level 3 intensive care on arrival in the recovery room. Three activation periods of 水 xtended post-anesthetic care in PACU service (10 Feb - 26 Apr 2020 / 27 Jul - 13 Sep 2020 / 14 Dec 2020 - 28 Feb 2021), and performed case matching with the postoperative patient with similar clinical characteristics entering intensive care unit directly in recent 10 years, with each case matched with specifically 5 control. We evaluate the value-based health care efficacy, including the amount of healthcare expenditure based on bed occupancy and manpower, rate of elective discharge to intensive care unit from extended post-anesthetic care in PACU, rate of unanticipated intensive care admission within 48hrs upon discharge to the general ward, and length of hospital stay, and the total number of ICU bed spared.
The staff attitude survey, with the aim to investigate the staff perception towards the implementation of TMH extended post-anesthetic care in PACU during COVID-19 pandemics based on the Technology Acceptance Model in healthcare. We designed a questionnaire based on Technology Acceptance Model, and distributed it to medical and nursing staff involved in extended post anaesthetic care in PACU service, and evaluate the perceived usefulness, perceived ease of use, social influence of subjective norm, and perceived behavioral control of facilitating condition. A differential analysis would be conducted for the evaluation.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
total number of ICU bed days spared
时间窗: during study period, up to 1 year
次要结局
- amount of healthcare expenditures based on bed occupancy and manpower(during study period, up to 1 year)
- number of unanticipated intensive care unit admission within 48 hours upon discharge to general ward(48 hour)
- length of hospital stays(during admission or patient death, typically up to 1 month)
- rate of elective discharge to the intensive care unit(After extended post anaesthetic care in PACU service by case. Up to 24 hour)
研究者
Lau Hon Wai
Medical Officer
Tuen Mun Hospital