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基于医护一体化的乳腺癌化疗门诊全程管理模式的构建与实践

郭海凌 张佳华 张帆 龙一方 王常珺

协和医学杂志2025,Vol.16Issue(4):1026-1032,7.
协和医学杂志2025,Vol.16Issue(4):1026-1032,7.DOI:10.12290/xhyxzz2024-0610

基于医护一体化的乳腺癌化疗门诊全程管理模式的构建与实践

Construction and Practice of the Whole Management Model of Breast Cancer Chemotherapy Outpatient Clinic Based on Doctor-nurse Integration Mode

郭海凌 1张佳华 1张帆 1龙一方 1王常珺1

作者信息

  • 1. 中国医学科学院北京协和医院乳腺外科,北京 100730
  • 折叠

摘要

Abstract

Objective To explore the establishment,implementation,and outcomes of an integrated physician-nurse team-based comprehensive management model for breast cancer chemotherapy outpatients,ai-ming to provide a reference for standardized patient care.Methods In January 2019,the Breast Surgery De-partment of Peking Union Medical College Hospital developed an integrated physician-nurse team and estab-lished a full-cycle management pathway covering the pre-chemotherapy,chemotherapy,and inter-cycle phases.This model featured appointment-based scheduling,time-segmented visits,and closed-loop patient management.Key performance indicators-including healthcare efficiency,chemotherapy safety,staffing ratios,and satisfaction levels among patients and healthcare providers-were compared between pre-implementation(2018)and post-imple-mentation(2019)periods.Results Before implementation,patient waited times ranged from 30 to 120(75.40±20.97)minutes,with an annual chemotherapy volume of 8 715 cases.Two ward nurses were routinely redeployed daily to support the chemotherapy clinic.Post-implementation,patients received timely chemotherapy per scheduled appointments without delays,annual chemotherapy volume in-creased to 10 101 cases,and staffing between two chemotherapy units became flexibly adjustable.Ward nurses transitioned from an on-call to a reserve role.Adverse events(chemotherapy-related,catheter-related,and nursing incidents)remained at 0,consistent with pre-implementation levels.Both patient and staff satisfaction scores significantly improved across all domains(all P<0.05).Conclusions The integrated physician-nurse team-based chemotherapy management model enhances service efficiency,ensures treatment safety,optimizes workforce allocation,and improves satisfaction among patients and healthcare providers.

关键词

医护一体化/乳腺癌/化疗门诊/全程管理

Key words

doctor-nurse integration mode/breast cancer/chemotherapy outpatient clinic/whole process management

分类

医药卫生

引用本文复制引用

郭海凌,张佳华,张帆,龙一方,王常珺..基于医护一体化的乳腺癌化疗门诊全程管理模式的构建与实践[J].协和医学杂志,2025,16(4):1026-1032,7.

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