{"id":3257,"date":"2020-11-03T16:22:28","date_gmt":"2020-11-03T16:22:28","guid":{"rendered":"\/?p=3257"},"modified":"2020-11-03T16:22:28","modified_gmt":"2020-11-03T16:22:28","slug":"flexible-healthcare-infrastructure-can-alleviate-ae-pressure","status":"publish","type":"post","link":"https:\/\/www.vanguardhealthcare.co.uk\/cs_cz\/flexible-healthcare-infrastructure-can-alleviate-ae-pressure\/","title":{"rendered":"Flexibiln\u00ed zdravotnick\u00e1 infrastruktura m\u016f\u017ee zm\u00edrnit tlak A&E"},"content":{"rendered":"

Vzhledem k tomu, \u017ee n\u00e1v\u0161t\u011bvnost A&E stoup\u00e1 a kapacita zdravotn\u00ed p\u00e9\u010de je nad\u00e1le omezena pot\u0159ebou pojmout pacienty s Covid-19, mohla by jednotka do\u010dasn\u00e9ho lehk\u00e9ho poran\u011bn\u00ed (MIU) nebo centrum urgentn\u00ed p\u00e9\u010de (UTC) pomoci sn\u00ed\u017eit tlak v kr\u00e1tkodob\u00e9m a\u017e st\u0159edn\u011bdob\u00e9m horizontu a p\u0159idat \u017eivotn\u011b d\u016fle\u017eit\u00e9 extra kapacitu pro l\u00e9\u010dbu pacient\u016f.<\/p>\n

Ob\u00e1v\u00e1me se, \u017ee druh\u00e1 vlna m\u016f\u017ee zp\u016fsobit, \u017ee odd\u011blen\u00ed A&E budou v t\u00e9to zimn\u00ed sez\u00f3n\u011b znovu zahlcena. Zat\u00edmco nov\u00fd model sjedn\u00e1v\u00e1n\u00ed sch\u016fzek, kter\u00fd vl\u00e1da testuje, by m\u011bl zkr\u00e1tit \u010dekac\u00ed doby na nal\u00e9hav\u00e9 p\u0159\u00edpady, bude zapot\u0159eb\u00ed \u0161ir\u0161\u00ed p\u0159\u00edstup ke zlep\u0161en\u00ed toku pacient\u016f.<\/p>\n

Dlouhodob\u00e1 z\u00e1le\u017eitost<\/strong><\/p>\n

Rostouc\u00ed tlak na pohotovostn\u00ed odd\u011blen\u00ed je dlouhodob\u00fdm probl\u00e9mem, kter\u00fd je zp\u016fsoben \u0159adou demografick\u00fdch a dal\u0161\u00edch faktor\u016f, ale rozsah probl\u00e9mu se postupem \u010dasu zv\u00fd\u0161il a vyvrcholil b\u011bhem lo\u0148sk\u00e9 zimy. Za posledn\u00edch p\u011bt let vzrostla n\u00e1v\u0161t\u011bvnost hlavn\u00edch odd\u011blen\u00ed A&E ve v\u0161eobecn\u00fdch nemocnic\u00edch v\u00edce ne\u017e 10%,<\/a> s n\u00e1r\u016fstem mezi lety 2018 a 2019 nejv\u00fdrazn\u011bj\u0161\u00ed na 4,9%.<\/p>\n

P\u0159i obsazenosti l\u016f\u017eek na v\u00edce ne\u017e 90% celost\u00e1tn\u011b<\/a>Mnoho za\u0159\u00edzen\u00ed m\u011blo p\u0159ed pandemi\u00ed maxim\u00e1ln\u00ed kapacitu, co\u017e znamen\u00e1, \u017ee syst\u00e9m je velmi m\u00e1lo flexibiln\u00ed, aby se vyrovnal s do\u010dasn\u00fdmi n\u00e1r\u016fsty popt\u00e1vky, jako je nap\u0159\u00edklad Covid-19. Odhaduje se, \u017ee po\u017eadavek na soci\u00e1ln\u00ed distancov\u00e1n\u00ed tak\u00e9 podstatn\u011b sn\u00ed\u017eil z\u00e1kladnu postel\u00ed NHS England.<\/p>\n

Rostouc\u00ed popt\u00e1vka v kombinaci s omezenou a sni\u017euj\u00edc\u00ed se kapacitou vedla k tomu, \u017ee se \u010dekac\u00ed doby v pr\u016fb\u011bhu \u010dasu podstatn\u011b prodlu\u017eovaly. Celost\u00e1tn\u011b 23,81 TP4T pacient\u016f<\/a> v hlavn\u00edch odd\u011blen\u00edch A&E \u010dekala v lo\u0148sk\u00e9m roce v\u00edce ne\u017e \u010dty\u0159i hodiny ve srovn\u00e1n\u00ed s 8,51 TP4T v roce 2014, p\u0159i\u010dem\u017e podobn\u00e9 trendy byly pozorov\u00e1ny ve Skotsku a Walesu.<\/p>\n

Toto je nyn\u00ed nal\u00e9hav\u00fd probl\u00e9m. P\u0159epln\u011bnost m\u016f\u017ee znamenat vy\u0161\u0161\u00ed riziko p\u0159enosu viru a pot\u0159eba odd\u011blit pacienty s podez\u0159en\u00edm na Covid-19 od pacient\u016f bez Covidu zvy\u0161uje okam\u017eit\u00fd tlak. Bez ohledu na metriku pou\u017eitou k m\u011b\u0159en\u00ed v\u00fdkonnosti A&E je jasn\u00e9, \u017ee situace p\u0159ed vstupem do zimn\u00ed sez\u00f3ny nen\u00ed ide\u00e1ln\u00ed.<\/p>\n

Sn\u00ed\u017een\u00ed popt\u00e1vky po A&E<\/strong><\/p>\n

Z\u00e1kladn\u00ed n\u00e1r\u016fst popt\u00e1vky po zdravotn\u00ed p\u00e9\u010di nebude v pr\u016fb\u011bhu \u010dasu sl\u00e1bnout a z dlouhodob\u00e9ho hlediska bude kl\u00ed\u010dov\u00e9 tak\u00e9 p\u0159id\u00e1n\u00ed v\u011bt\u0161\u00ed kapacity v podob\u011b v\u011bt\u0161\u00edho prostoru na odd\u011blen\u00ed a nov\u011b budovan\u00fdch nemocnic.<\/p>\n

Slu\u017eby urgentn\u00ed a pohotovostn\u00ed p\u00e9\u010de ji\u017e proch\u00e1zely transformac\u00ed, aby se dos\u00e1hlo zjednodu\u0161en\u00e9ho a integrovan\u00e9ho syst\u00e9mu a zlep\u0161en\u00e9ho toku pacient\u016f, ale n\u00e1stup Covid-19 urychlil tempo zm\u011bn. Vzhledem k sou\u010dasn\u00e9 situaci je nepravd\u011bpodobn\u00e9, \u017ee by A&E bylo t\u00edm nejvhodn\u011bj\u0161\u00edm m\u00edstem pro pacienty s ur\u010dit\u00fdmi onemocn\u011bn\u00edmi.<\/p>\n

Nov\u00fd syst\u00e9m, kter\u00fd zahrnuje pracovn\u00edky NHS 111, kte\u0159\u00ed nasm\u011bruj\u00ed pacienty na klinicky nejvhodn\u011bj\u0161\u00ed slu\u017ebu, by m\u011bl sn\u00ed\u017eit p\u0159epln\u011bnost v \u010dek\u00e1rn\u00e1ch, sn\u00ed\u017eit riziko a omezit zbyte\u010dn\u00e9 n\u00e1v\u0161t\u011bvy na pohotovosti. To v\u0161ak m\u016f\u017ee tak\u00e9 p\u0159edstavovat probl\u00e9my, pokud jde o fyzick\u00fd prostor a kapacitu v jin\u00fdch \u010d\u00e1stech syst\u00e9mu zdravotn\u00ed p\u00e9\u010de. Lid\u00e9 odveden\u00ed z odd\u011blen\u00ed A&E budou muset n\u011bkam j\u00edt.<\/p>\n

Zlep\u0161en\u00ed toku pacient\u016f<\/strong><\/p>\n

Vytvo\u0159en\u00ed spole\u010dn\u00e9 MIU nebo UTC na stejn\u00e9m m\u00edst\u011b jako odd\u011blen\u00ed A&E umo\u017e\u0148uje nemocnic\u00edm sd\u00edlet zdroje v r\u00e1mci pracovi\u0161t\u011b a pacienty l\u00e9\u010dit v nejvhodn\u011bj\u0161\u00edm prost\u0159ed\u00ed, co\u017e vede ke zkr\u00e1cen\u00ed \u010dekac\u00edch dob a efektivn\u011bj\u0161\u00edmu toku pacient\u016f. Sn\u00ed\u017een\u00ed tlaku na l\u016f\u017ekov\u00fdch l\u016f\u017ek\u00e1ch je tak\u00e9 mo\u017en\u00e9, proto\u017ee pacienti jsou vid\u011bt a l\u00e9\u010deni rychleji a je m\u00e9n\u011b pravd\u011bpodobn\u00e9, \u017ee jim bude p\u0159id\u011bleno l\u016f\u017eko.<\/p>\n

Dopln\u011bn\u00ed kapacity ve form\u011b nov\u00e9 budovy nebo trval\u00e9ho roz\u0161\u00ed\u0159en\u00ed v\u0161ak m\u016f\u017ee b\u00fdt obt\u00ed\u017en\u00e9 kv\u016fli omezen\u00edm na m\u00edst\u011b a reorganizace pohotovostn\u00edho odd\u011blen\u00ed nebo v\u00fdstavba jednotky MIU nebo UTC m\u016f\u017ee n\u011bjakou dobu trvat.<\/p>\n

Flexibiln\u00ed, spole\u010dn\u011b um\u00edst\u011bn\u00e9 mobiln\u00ed nebo modul\u00e1rn\u00ed MIU nebo UTC lze rychle z\u0159\u00eddit vedle st\u00e1vaj\u00edc\u00edho odd\u011blen\u00ed A&E, aby se okam\u017eit\u011b uvolnil tlak. Pou\u017eit\u00edm do\u010dasn\u00e9ho \u0159e\u0161en\u00ed lze velmi rychle dos\u00e1hnout nov\u00e9ho zp\u016fsobu pr\u00e1ce, p\u0159i\u010dem\u017e prob\u00edh\u00e1 trvalej\u0161\u00ed rekonfigurace.<\/p>\n

Spole\u010dn\u011b um\u00edst\u011bn\u00e1 MIU<\/strong><\/p>\n

Jedna nemocnice, kter\u00e1 to ud\u011blala, je kr\u00e1lovsk\u00e1 o\u0161et\u0159ovna v Edinburghu<\/a>, kter\u00e1 z\u0159\u00eddila MIU v roce 2019. Veden\u00ed nemocnice zjistilo, \u017ee lid\u00e9 \u010dekaj\u00ed v A&E na l\u00e9\u010dbu stav\u016f, kter\u00e9 by bylo mo\u017en\u00e9 l\u00e9\u010dit jinde ve zdravotnick\u00e9m syst\u00e9mu, co\u017e vystavilo odd\u011blen\u00ed tlaku a vedlo to k del\u0161\u00ed \u010dekac\u00ed dob\u011b pro pacienty.<\/p>\n

NHS Lothian cht\u011bla pomoci v\u00edce lidem, aby byli o\u0161et\u0159eni rychle, efektivn\u011b a v co nejpohodln\u011bj\u0161\u00edm prost\u0159ed\u00ed, a tak bylo p\u0159ijato rozhodnut\u00ed vytvo\u0159it MIU v bl\u00edzkosti odd\u011blen\u00ed A&E nemocnice, kter\u00e9 by mohlo l\u00e9\u010dit lidi s m\u00e9n\u011b v\u00e1\u017en\u00fdmi zran\u011bn\u00edmi. V\u00fdsledn\u00e9 za\u0159\u00edzen\u00ed bylo vytvo\u0159eno pomoc\u00ed mobiln\u00edho lamin\u00e1rn\u00edho opera\u010dn\u00edho s\u00e1lu v kombinaci s modul\u00e1rn\u00edmi budovami.<\/p>\n

Komplex poskytuje ve\u0161ker\u00fd prostor pot\u0159ebn\u00fd k poskytov\u00e1n\u00ed kompletn\u00edch slu\u017eeb MIU, v\u010detn\u011b recepce a \u010dek\u00e1rny, m\u00edstnost\u00ed pro o\u0161et\u0159en\u00ed, \u010dist\u00fdch a \u0161pinav\u00fdch technick\u00fdch prostor a \u0161atny. D\u016fle\u017eit\u00fdm po\u017eadavkem bylo, aby jednotka byla p\u0159\u00edstupn\u00e1 ze st\u00e1vaj\u00edc\u00edho odd\u011blen\u00ed A&E, \u010deho\u017e bylo dosa\u017eeno vybudov\u00e1n\u00edm \u00fa\u010delov\u00e9 l\u00e1vky spojuj\u00edc\u00ed ob\u011b odd\u011blen\u00ed dohromady.<\/p>\n

Po instalaci m\u011blo za\u0159\u00edzen\u00ed okam\u017eit\u00fd pozitivn\u00ed dopad. B\u011bhem prvn\u00ed hodiny bylo z A&E odklon\u011bno v\u00edce ne\u017e 20 pacient\u016f a od otev\u0159en\u00ed bylo v MIU denn\u011b o\u0161et\u0159eno 80 a\u017e 100 pacient\u016f s \u0159adou drobn\u00fdch poran\u011bn\u00ed, jako jsou zlomeniny, poran\u011bn\u00ed m\u011bkk\u00fdch tk\u00e1n\u00ed a kousnut\u00ed. M\u00edstn\u00ed MIU tak\u00e9 zkracuje dobu, po kterou lid\u00e9 \u010dekaj\u00ed na prohl\u00eddku, a sni\u017euje tlak na l\u016f\u017ekov\u00e1 m\u00edsta v hlavn\u00ed nemocnici.<\/p>\n

Flexibiln\u00ed zdravotn\u00ed benefity<\/strong><\/p>\n

Mobiln\u00ed a modul\u00e1rn\u00ed do\u010dasn\u00e9 jednotky mohou b\u00fdt pou\u017eity k poskytnut\u00ed dal\u0161\u00edho klinick\u00e9ho prostoru na kr\u00e1tkodob\u00e9 nebo dlouhodob\u00e9 b\u00e1zi. Flexibiln\u00ed povaha do\u010dasn\u00fdch mobiln\u00edch nebo modul\u00e1rn\u00edch jednotek MIU znamen\u00e1, \u017ee je lze \u010dasem upravovat podle toho, jak se m\u011bn\u00ed po\u017eadavky a kapacita. Mohou b\u00fdt tak\u00e9 vy\u0159azeny z provozu, p\u0159esunuty nebo znovu pou\u017eity, jakmile bude zavedeno trvalej\u0161\u00ed \u0159e\u0161en\u00ed.<\/p>\n

Flexibiln\u00ed \u0159e\u0161en\u00ed tak\u00e9 umo\u017e\u0148uj\u00ed nemocnic\u00edm otestovat sc\u00e9n\u00e1\u0159e a prok\u00e1zat obchodn\u00ed p\u0159\u00edpady p\u0159edt\u00edm, ne\u017e investuj\u00ed zna\u010dn\u00e9 mno\u017estv\u00ed pen\u011bz do nov\u00e9 nebo p\u0159ed\u011blan\u00e9 st\u00e1l\u00e9 budovy. Krom\u011b zkou\u0161en\u00ed nov\u00fdch proces\u016f nebo pracovn\u00edch postup\u016f lze do\u010dasnou jednotku pou\u017e\u00edt tak\u00e9 ke zkou\u0161en\u00ed nov\u00e9 technologie, co\u017e umo\u017e\u0148uje nemocnic\u00edm vylep\u0161ovat a do budoucna zaji\u0161\u0165ovat syst\u00e9my.<\/p>\n

Modul\u00e1rn\u00ed \u0159e\u0161en\u00ed v\u0161ak nemus\u00ed b\u00fdt do\u010dasn\u00e1; modern\u00ed modul\u00e1rn\u00ed stavby mohou b\u00fdt zcela p\u0159izp\u016fsobeny a navr\u017eeny tak, aby hladce zapadly do st\u00e1vaj\u00edc\u00ed budovy. Instalace modul\u00e1rn\u00ed jednotky je mnohem rychlej\u0161\u00ed ne\u017e stavba tradi\u010dn\u00edm zp\u016fsobem \u2013 dobu v\u00fdstavby modul\u00e1rn\u00ed jednotky lze zkr\u00e1tit t\u00e9m\u011b\u0159 o 50% \u2013 a je zde men\u0161\u00ed riziko nep\u0159\u00edzniv\u00e9ho po\u010das\u00ed nebo jin\u00fdch vn\u011bj\u0161\u00edch faktor\u016f zp\u016fsobuj\u00edc\u00edch zpo\u017ed\u011bn\u00ed.<\/p>\n

Nal\u00e9hav\u00e1 pot\u0159eba<\/strong><\/p>\n

Covid-19 dost\u00e1v\u00e1 syst\u00e9m, kter\u00fd u\u017e byl napjat\u00fd a pod tlakem. Po\u010det pacient\u016f nav\u0161t\u011bvuj\u00edc\u00edch hlavn\u00ed A&E odd\u011blen\u00ed ve v\u0161eobecn\u00fdch nemocnic\u00edch m\u00e1 za posledn\u00edch 20 let t\u00e9m\u011b\u0159 zdvojn\u00e1sobil<\/a>, p\u0159i\u010dem\u017e kl\u00ed\u010dov\u00fdm faktorem je na\u0161e st\u00e1rnouc\u00ed a rychle rostouc\u00ed populace. Tato kategorie pacient\u016f tak\u00e9 vyu\u017e\u00edv\u00e1 v\u00edce l\u016f\u017eek ne\u017e ostatn\u00ed lid\u00e9 po urgentn\u00edm p\u0159\u00edjmu.<\/p>\n

Sn\u00ed\u017een\u00ed prim\u00e1rn\u00ed, komunitn\u00ed a soci\u00e1ln\u00ed p\u00e9\u010de tak\u00e9 nep\u0159\u00edmo zp\u016fsobilo n\u00e1r\u016fst n\u00e1v\u0161t\u011bv a hospitalizac\u00ed na A&E, kter\u00fdm lze p\u0159edch\u00e1zet, nap\u0159\u00edklad t\u011bch souvisej\u00edc\u00edch s drobn\u00fdmi zran\u011bn\u00edmi, intoxikac\u00ed alkoholem nebo drogami, demenc\u00ed a du\u0161evn\u00edm zdrav\u00edm, a obecn\u00fd nedostatek l\u016f\u017eek m\u00e1 potenci\u00e1l zp\u016fsobit blok\u00e1dy jinde, v\u010detn\u011b odd\u011blen\u00ed A&E. Pro p\u0159izp\u016fsoben\u00ed se nov\u00fdm podm\u00ednk\u00e1m a zaji\u0161t\u011bn\u00ed toho, aby celkov\u00e1 kapacita byla schopna pokr\u00fdt p\u0159edpokl\u00e1dan\u00fd demografick\u00fd r\u016fst, je zapot\u0159eb\u00ed trvalej\u0161\u00edho \u0159e\u0161en\u00ed.<\/p>\n

Jak se v\u0161ak bl\u00ed\u017e\u00ed zima, nen\u00ed dost \u010dasu \u010dekat na implementaci dlouhodob\u00fdch \u0159e\u0161en\u00ed. Existuje v\u00e1\u017en\u00e9 riziko p\u0159elidn\u011bn\u00ed, zt\u00ed\u017een\u00ed soci\u00e1ln\u00edho distancov\u00e1n\u00ed a zv\u00fd\u0161en\u00ed rizika p\u0159enosu a nyn\u00ed je t\u0159eba zav\u00e9st praktick\u00e1 \u0159e\u0161en\u00ed.<\/p>\n

Spole\u010dn\u011b um\u00edst\u011bn\u00e9 modul\u00e1rn\u00ed MIU nebo UTC mohou p\u0159idat flexibiln\u00ed kapacitu, co\u017e umo\u017e\u0148uje nemocnic\u00edm implementovat doporu\u010den\u00e9 zm\u011bny, ani\u017e by musely \u010dekat na proveden\u00ed velk\u00fdch prac\u00ed nebo na novou budovu. V\u0161echny nemocnice jsou jin\u00e9 a do\u010dasn\u00e9 \u0159e\u0161en\u00ed poskytuje p\u0159\u00edle\u017eitost otestovat nov\u00e9 koncepty, abyste vid\u011bli, jak jim to bude fungovat, ne\u017e se zav\u00e1\u017eou k podstatn\u00fdm investic\u00edm.<\/p>\n

B\u00fdt v kontaktu<\/a> a zjist\u011bte v\u00edce o na\u0161ich modul\u00e1rn\u00edch \u0159e\u0161en\u00edch pro m\u00edstn\u00ed MIU nebo UTC.<\/p>","protected":false},"excerpt":{"rendered":"

Vzhledem k tomu, \u017ee n\u00e1v\u0161t\u011bvnost A&E stoup\u00e1 a kapacita zdravotn\u00ed p\u00e9\u010de je nad\u00e1le omezena pot\u0159ebou pojmout pacienty s Covid-19, mohla by jednotka do\u010dasn\u00e9ho lehk\u00e9ho poran\u011bn\u00ed (MIU) nebo centrum urgentn\u00ed p\u00e9\u010de (UTC) pomoci sn\u00ed\u017eit tlak v kr\u00e1tkodob\u00e9m a\u017e st\u0159edn\u011bdob\u00e9m horizontu a p\u0159idat \u017eivotn\u011b d\u016fle\u017eit\u00e9 extra kapacitu pro l\u00e9\u010dbu pacient\u016f.<\/p>","protected":false},"author":1,"featured_media":1361,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2,115],"tags":[142,127,5,4],"class_list":["post-3257","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-products-and-services","tag-estates","tag-minor-injuries-unit-miu","tag-mobile","tag-modular"],"acf":[],"yoast_head":"\nFlexible healthcare infrastructure can alleviate A&E pressure - 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