JP5575672B2 - Bed management support system, bed management support method, and bed management support program - Google Patents

Description

  The present invention relates to a bed management support system, a bed management support method, and a bed management support program.

  Due to changes in hospital facility standards due to recent medical system reforms, the number of beds (the number of beds for inpatients), which can be said to be excessive compared to other developed countries, is in the direction of reduction. In addition, the introduction of clinical path (critical path) and DPC (Diagnosis Procedure Combination) has promoted reduction in average hospital stay and functional differentiation between hospitals and clinics. Against this background, the turnover rate of beds is increasing in acute hospitals, and inpatients with high medical dependence occupy most of the beds. For this reason, there is a demand for providing hospitalized patients more effectively and efficiently with the limited medical resources that hospitals have.

  In order to achieve such a subject, it is required to perform bed management appropriately. Here, “bed management” refers to a method of providing a bed, such as “what kind of bed will be provided to inpatients” (for securing and providing a bed (bed) for a new inpatient and for that purpose. Hospital hospital discharge or adjustment of hospital transfer, and movement of beds within and between wards). For example, for serious patients, there are highly specialized treatments such as ICU (Intensive Care Unit), hospital beds that can be observed and responded immediately, and staff stations in the general wards. Bed management is performed to provide beds that are close to (including).

  The importance of this bed management has been recognized for a long time, and various efforts have been made. Specifically, for the purpose of effective use of resources (such as mixed wards) (for example, see Non-Patent Document 1), or for creating and managing bed maps for bed management using IT (For example, refer nonpatent literature 2) etc. are proposed.

Yukiko Sekiguchi et al., “Examination of problems and solutions by mixing wards”, Science of Nursing Practice, 2003, November, P10-P14 Hatsune Shinozaki, “Practice of bed management by unifying empty floor management”, Nursing Prospect, 2002, Vol. 27, No. 8, P882-887

  However, the above-mentioned conventional bed management efforts are mainly focused on increasing the utilization rate of the bed from a financial viewpoint, and regarding the maintenance and improvement of the safety and quality of medical services for patients, A lot depends on the experience and ability of medical professionals.

  The present invention has been made in view of the above, and provides a bed management support system, a bed management support method, and a bed management support program capable of maintaining and improving the safety and quality of medical services for patients. The purpose is to provide.

In order to solve the above-described problems and achieve the object, the bed management support system according to claim 1 is a bed management support system for supporting the management of a plurality of hospital beds, and is admitted to the hospital. Then, an evaluation result for a plurality of attributes or a plurality of needs related to a patient who receives a medical service in any one of the plurality of beds is correlated with a bed condition that should be possessed by a bed suitable for the patient's medical service. Bed management information configured to correlate the bed condition determination information storage means for storing the configured bed condition determination information, the plurality of beds, and the bed conditions satisfied by each of the plurality of beds. and bed management information storage means for storing, when the evaluation result for a plurality of attributes or needs of the patient has been identified by a predetermined method, corresponding to the specified evaluation results Floor condition, the bed condition specifying means for specifying by referring to the beds condition determination information stored in said beds condition determining information storing section, the beds to meet the beds condition specified in the bed condition specifying means The bed condition identifying means for identifying the bed suitable for the patient's medical service with reference to the bed management information stored in the bed management information storage means, the bed condition determination information storage means, A plurality of bed condition determination information corresponding to each of the plurality of functional items of the bed, wherein a plurality of bed condition determination information in which at least some of the evaluation results are different from each other and the bed conditions are different from each other is stored. The bed condition specifying unit is configured to store a plurality of bed conditions corresponding to the specified evaluation result in each of the plurality of bed condition determination information stored in the bed condition determination information storage unit. The bed specifying means refers to the bed management information stored in the bed management information storage means while referring to all of the plurality of bed conditions specified by the bed condition specifying means. If there is a bed that satisfies all of the plurality of bed conditions, the bed is identified as a bed suitable for the medical service of the patient. When it is determined that there is no bed that satisfies all of the plurality of bed conditions, at least one or more of the plurality of bed conditions is set based on the priority of the plurality of bed conditions set in advance. The rank of the bed condition having a high priority is changed to a higher rank, and it is determined whether or not there is a bed that satisfies all of the changed bed conditions. Bed Until it is determined that there is a bed satisfying all of the conditions, the change of the plurality of bed conditions and the determination of the presence / absence of the bed are sequentially repeated.

The bed management support method according to claim 2 is a bed management support method for supporting the management of a plurality of beds in a hospital, and is admitted to the hospital and receives a medical service in any of the plurality of beds. The bed condition determination information configured to correlate the evaluation results for a plurality of attributes or needs related to the patient and the bed conditions that should be possessed by the bed suitable for the patient's medical service is obtained from the bed management support system. Bed management information configured to correlate the bed condition determination information storage step to be stored in the bed condition determination information storage unit, the plurality of beds, and the bed conditions satisfied by each of the plurality of beds, In the bed management information storage step of storing in the bed management information storage means of the bed management support system, and in the bed management support system, a plurality of attributes of the patient When the evaluation result for the bed is specified by a predetermined method, the bed condition corresponding to the specified evaluation result is specified with reference to the bed condition determination information stored in the bed condition determination information storage means. The bed management information stored in the bed management information storage means as a bed suitable for the patient's medical service, wherein the bed satisfying the bed conditions specified in the bed condition specifying step and the bed condition specifying step A bed specifying step that is specified with reference, and in the bed condition determination information storing step, a plurality of bed condition determination information corresponding to each of the plurality of functional items of the bed, and at least of the evaluation result A plurality of bed condition determination information that is partially different from each other and the bed conditions are different from each other is stored, and in the bed condition specifying step, A plurality of bed conditions corresponding to the specified evaluation results are specified with reference to each of the plurality of bed condition determination information stored in the bed condition determination information storage means, and in the bed specification step, While referring to the bed management information stored in the bed management information storage means, determine whether there is a bed that satisfies all of the plurality of bed conditions specified in the bed condition specifying step, When it is determined that there is a bed that satisfies all of the plurality of bed conditions, the bed is identified as a bed that is suitable for the patient's medical service, and there is a bed that satisfies all of the plurality of bed conditions. If it is determined not to, based on the priorities of the plurality of bed conditions set in advance, at least one of the bed conditions having a high priority among the plurality of bed conditions. The rank is changed to a higher rank, it is determined whether or not there is a bed that satisfies all of the changed bed conditions, and thereafter, all of the changed bed conditions are satisfied. The change of the plurality of bed conditions and the determination of the presence / absence of the bed are sequentially repeated until it is determined that the bed exists.

Bed management assistance program according to claim 3, to perform the method of claim 2 to the computer.

According to the bed management support system according to claim 1, the bed management support method according to claim 2 , or the bed management support program according to claim 3 , an evaluation result for a plurality of attributes or a plurality of needs of a patient is obtained. Because the corresponding bed conditions are identified, it becomes possible to accurately and quickly grasp the bed conditions that meet multiple attributes or multiple needs of the patient, and maintain and improve the safety and quality of clinical services for patients. Can be achieved.
In addition, since the bed condition corresponding to each of the plurality of function items of the bed is specified, it becomes possible to accurately and quickly grasp the bed condition that matches each function item.
In addition, since the bed that satisfies the bed conditions is identified as the bed suitable for the patient's medical service, it is possible to accurately and quickly grasp the bed that meets multiple attributes or multiple needs of the patient, It is possible to maintain and improve the safety and quality of medical services for patients.
In addition, since a bed that satisfies all of the multiple bed conditions is identified as a bed suitable for the patient's medical service, it is possible to accurately and quickly grasp a bed that meets multiple attributes or multiple needs of the patient. It becomes possible.

It is a figure which illustrates a patient attribute need item table. It is a figure which illustrates a patient attribute needs evaluation table. It is a figure which illustrates a bed related function item table. It is a figure which illustrates a bed function evaluation table. It is a figure which illustrates the 1st bed condition judgment table. It is a figure which illustrates the 2nd bed condition judgment table. It is a figure which illustrates the 3rd bed condition judgment table. It is a block diagram which illustrates functionally the bed management support system concerning an embodiment of the invention functionally. It is a figure which illustrates a bed management table. It is a flowchart of a hospital bed management support process.

  Hereinafter, embodiments of a bed management support system, a bed management support method, and a bed management support program according to the present invention will be described in detail with reference to the drawings. However, the present invention is not limited by this embodiment.

(concept)
First, basic concepts of a bed management support system, a bed management support method, and a bed management support program will be described. The bed management support system, the bed management support method, and the bed management support program are for supporting the management of a plurality of beds in a hospital. More specifically, any of a plurality of beds that have been admitted to a hospital. With regard to a patient who receives a medical service, a bed suitable for the patient is specified.

(Concept-Bed management process)
In the present embodiment, the bed management process is considered to be composed of the following six steps (1) to (6). The steps (1) to (3) and (6) are steps common to newly inpatients and inpatients, and the steps (4) and (5) are applied only to inpatients. It is a step.
(1) State evaluation step The state evaluation step is a step of evaluating the state of each patient at the time when the assessment is performed by performing an assessment on the state of each patient.
(2) Patient attribute needs deriving step The patient attribute needs deriving step is a step of deriving patient attribute needs based on the results of the assessment performed in the state evaluation step. Patient attribute needs is a general term for patient attributes and needs, and is information necessary for determining a bed.
(3) Necessary bed function deriving step The necessary bed function deriving step is a step of deriving candidates for bed functions (hereinafter referred to as necessary bed functions) necessary to meet the patient's attribute needs derived in the patient attribute needs deriving step. It is.
(4) Steps for comparing the current bed and necessary bed function The steps for comparing the current bed and necessary bed function are the bed (currently placed bed) and the necessary bed function derived in the necessary bed function derivation step. It is a step which compares with.
(5) Adjustment candidate bed deriving step The adjustment candidate bed deriving step is a bed for accepting a patient different from the currently accepted patient based on the comparison result of the comparison step of the presently arranged bed and the necessary bed function (= adjustment candidate) This is a step of deriving a hospital bed. For example, if a particular bed that is currently accepting a patient has a higher function than the patient's required bed function, it may be preferable to accept another patient on that bed. Is the adjustment candidate bed.
(6) Bed Determining Step The bed determining step is a step of determining the beds of new inpatients and patients who are candidates for translocation, comprehensively considering the nursing power that can be provided and the attributes and needs of each patient.

(Concept-Basic concept of bed derivation)
In order to achieve the above steps (1) to (6), it is considered necessary to grasp the necessary (1) to (3).
(1) Grasp of patient attribute needs to be captured in order to derive bed function candidates (2) Grasp of bed-related function items to be derived (3) Derive necessary bed function candidates from the results of evaluating patient attribute needs The logic to do

  As common to the different requirements of grasping patient attribute needs to be understood in order to derive the bed function candidates in (1) above and grasping of bed related function items to be derived in (2) above, “Inpatient medical service” "Function" was examined. The in-patient medical service is a medical service that a patient receives after being admitted to a hospital and is affected by a hospital bed that the patient has received. Since the patient receives in-patient medical service and the bed is for providing it, by examining the in-patient medical service function, the patient attribute needs to be grasped in order to derive the above-mentioned bed function candidate (1) It is possible to examine different requirements for grasping and grasping the bed related function item to be derived in (2) above.

(Concept-Hospitalization service function)
In the process of hospitalization, it is characteristic that patients “live” while receiving “medical treatment”. In addition, inpatients often suffer from ADL (Activities of Daily Living) ability due to illnesses and invasion by medical interventions such as medications and tests, resulting in medical accidents. Is likely to happen. In other words, it is necessary to consider measures for preventing accidents caused by patients. From these facts, it can be understood that the in-patient medical service function is largely composed of the following three.
(A) Medical practice providing function The medical practice providing function is a function in which a medical person provides a medical practice.
(B) Life support function The life support function is a function that supports a patient living in a hospital.
(C) Patient safety function The patient safety function is a function for maintaining patient safety.

(Concept-hospitalization service function fulfillment requirement)
When fulfilling the functions (A) to (C), the requirements that greatly influence the effects of these functions are as follows.
(A) Requirements affecting the effect of the medical practice provision function The medical practice is provided by the “medical person”, and the “equipment / function” is required in order to perform appropriate medical care in the acute hospital. Therefore, the following two requirements should be considered in this function.
(A-1) Relevance to medical personnel performing treatment (A-2) Relevance to medical equipment / functions (B) Requirements that affect the effectiveness of life support functions Patients have reduced ADL ability and hospitals The side needs to provide functions that support life. This is mainly provided by "medical personnel" such as nurses. In addition, it is necessary to consider the relationship with “living facilities” in order to live a normal life. Furthermore, current medical insurance coverage is in large rooms, and the majority of patients will be hospitalized in large rooms. In other words, you will have some relationship with other patients (= “residents”) while you are in the hospital. Therefore, the following three requirements should be considered in this function.
(B-1) Relevance to medical care providers performing life care (B-2) Relevance to living facilities (B-3) Relevance to residents (C) Requirements affecting the effectiveness of patient safety functions Patients Since ADL and judgment ability are lower than those of healthy individuals, it is desirable to take appropriate measures based on the possibility of “accidents” that occur in the patient's situation and their contents. In other words, the requirements to be considered here are as follows.
(C-1) Relevance to accidents caused by patients The following (A-1), (A-2), (B-1) to (B-3) necessary for providing an inpatient medical service function , And (C-1) are referred to as “hospital care service function satisfaction requirements”.

(Concept-Patient attribute needs item table)
After conducting such examinations, we investigated the inpatient medical care work in hospital wards, further examined the relationship between inpatient medical service function fulfillment requirements and patient attribute needs, and used these results as a patient attribute needs item table. Tidy. This patient attribute need item table is illustrated in FIG. This patient attribute need item table includes items “hospital care service function fulfillment requirements (represented as requirements in FIG. 1; the same applies in each figure below)”, item “patient attribute needs”, item “element”, item “specific example”, And the item “remarks” and information corresponding to these items are associated with each other. Information corresponding to the item “admission medical service function satisfaction requirement” is the above-mentioned inpatient medical service function satisfaction requirement. The information corresponding to the item “patient attribute needs” is patient attribute needs for satisfying each hospitalization service function fulfillment requirement. The information corresponding to the item “element” is a specific element necessary for satisfying each patient attribute need. For example, in order to satisfy the “relevance with the medical caregiver performing the treatment”, which is the requirement for satisfying the in-patient medical service function, the “specialization of medical treatment / treatment”, “content of treatment”, and “intervention” "Frequency" must be satisfied, and in order to satisfy "specialty of medical treatment / treatment", it is necessary to satisfy the element "department in charge / disease (including special ones)" . The information corresponding to the item “specific example” is a specific example of each element. The information corresponding to the item “Remarks” is the policy and reason for organizing and consolidating each element. Moreover, the part described as “-” indicates that there is no corresponding information (the same applies to other tables).

(Concept-Patient attribute needs assessment table)
Next, as shown in the information corresponding to the item “Remarks”, each element in the patient attribute need item table of FIG. 1 was organized and aggregated, and the result was organized as a patient attribute need evaluation table. This patient attribute need evaluation table is illustrated in FIG. This patient attribute needs evaluation table is configured by associating items “patient attribute items”, items “evaluation categories”, and items “evaluation methods” with information corresponding to these items. The information corresponding to the item “patient attribute item” is a combination of the above-mentioned in-patient medical service function satisfaction requirements and elements that correspond to the in-hospital medical service function satisfaction requirements and are organized and aggregated. For example, the element “severity” and the element “emergency” in the patient attribute need item table of FIG. 1 are collected as the element “severity / emergency” in the patient attribute need evaluation table of FIG. The information corresponding to the item “evaluation category” is each category when the needs of each element are evaluated into a plurality of categories (here, four categories). Here, it is shown that needs increase from evaluation category 1 to evaluation category 4. Information corresponding to the item “evaluation method” is a method for evaluating the necessity of each element into a plurality of categories (here, four categories). As information corresponding to this item “evaluation method”, the existing assessment method is described as the method. However, even items that do not have an existing assessment method are items that have been appropriately determined by doctors and nurses, and can be evaluated.

(Concept-Bed-related function item table)
Next, the relationship between the in-patient medical service function satisfaction requirement and the bed function was examined, and the results of the examination were arranged as a bed related function item table. This bed related function item table is illustrated in FIG. This bed-related function item table includes items “hospital care service function fulfillment requirements”, item “bed-related functions”, item “elements”, item “specific examples”, and item “remarks”, and information corresponding to these items. Are associated with each other. Information corresponding to the item “admission medical service function satisfaction requirement” is the above-mentioned inpatient medical service function satisfaction requirement. The information corresponding to the item “bed-related function” is a function related to the bed and is a function for satisfying each hospitalization service function satisfaction requirement. The information corresponding to the item “element” is a specific element necessary for satisfying each bed related function. For example, in order to satisfy the “relevance with the medical caregiver who performs the treatment”, which is the requirement for satisfying the in-patient medical service function, “distance from the treatment provider” and “ease of treatment” are the bed-related functions. It is necessary to satisfy the “distance from the staff station”, which is an element, in order to satisfy the “distance from the treatment provider”. The information corresponding to the item “specific example” is a specific example of each element. The information corresponding to the item “Remarks” is the policy and reason for organizing and consolidating each element.

(Concept-Bed function evaluation table)
Next, as shown in the information corresponding to the item “Remarks”, the elements in the bed related function item table of FIG. 3 were organized and aggregated, and the results were organized as a bed function evaluation table. This bed function evaluation table is illustrated in FIG. This bed function evaluation table is configured by associating items “bed related function items” and items “rank” with information corresponding to these items. This is a combination of information corresponding to the item “bed-related function item”, the above-mentioned in-patient medical service function satisfaction requirement, and elements corresponding to each in-patient medical service function satisfaction requirement, which are organized and aggregated. For example, the element “severity category” and the element “specialized medical department” in the bed related function item table of FIG. 3 are aggregated as the element “specific function room / general room” in the bed related function item table of FIG. . The information corresponding to the item “rank” is each category when the needs of each element are evaluated into a plurality of categories (here, four categories). Here, it is shown that needs increase from rank 3 to rank A. The “specific function room” in this rank A has special functions that can be used for patients who belong to HCU / ICU or specialized medical department wards, have special equipment, or need special observation in general wards. Refers to a hospital room. Other ranks 1 to 3 are for general hospital rooms. In addition, it corresponds to the element “the number of beds in the hospital room” corresponding to the “relevance to medical equipment / function”, which is the requirement for satisfying inpatient medical service functions, and “relevance to residents”, which is the requirement for satisfying inpatient medical service functions If the same element is associated with different in-patient medical service function fulfillment requirements, such as the number of beds in the room, the other is omitted. (The portion described as “omitted due to duplication” in FIG. 4 indicates such omission).

(Concept-Bed condition derivation method)
Next, logic for deriving the rank shown in the bed function evaluation table of FIG. 4 from the patient needs evaluation result using the patient attribute need evaluation table of FIG. First, from the bed function evaluation table of FIG. 4, the bed condition derivation method determines the ranks of the elements “distance from staff station”, “number of beds in the room / specific room”, and “distance to toilet”. It can be seen that Although the necessary bed conditions are naturally limited by the “specialized department” and “gender” for the patient, the department and gender are already identified before hospitalization, and more generally the patient's situation Therefore, these are excluded as prerequisites for the bed condition derivation method.

(Concept-Bed condition judgment table)
In order to determine the ranks of these elements “distance from staff station”, “number of beds in the room / specific room”, and “distance to the toilet”, different bed condition determination tables are used. Hereinafter, the bed condition determination table for determining the rank of the element “distance from the staff station” is the “first bed condition determination table”, and the bed condition for determining the rank of the element “the number of beds in the room / specific room” The judgment table is called “second bed condition judgment table”, the bed condition judgment table for judging the rank of the element “distance to toilet” is called “third bed condition judgment table”, and these need to be distinguished from each other in particular. When there is no, it is collectively referred to as a “bed condition determination table”. In each bed condition judgment table, a judgment process based on the three functions (medical practice providing function, life support function, and patient safety function) constituting the above-mentioned hospitalization medical service function is constructed, and the bed function is classified according to these viewpoints. The unit to be determined is expressed as a “stage”. The order of the stages represents the order of viewpoints to be prioritized, and the subsequent stage is not determined depending on the determination result of the preceding stage. For example, if the determination result in the preceding stage 1 is the highest rank, the determination of the other stages in the subsequent stage is unnecessary.

  FIG. 5 illustrates a first bed condition determination table. The first bed condition determination table is configured by associating the item “stage 1”, the item “stage 2”, the item “stage 3”, the item “rank”, and information corresponding to these items with each other. ing. The information corresponding to the item “stage 1” is an evaluation result that should be considered first in order to determine the rank, and is an evaluation result that should be considered from the viewpoint of the degree of observation associated with the provision of medical practice.・ Evaluation result of “Urgentness” and evaluation result of “Possibility of state deterioration” are combined and considered. The information corresponding to the item “Stage 2” is an evaluation result that should be considered second in order to determine the rank, and is an evaluation result that should be considered from the viewpoint of patient-induced accident prevention (patient safety) accompanying the provision of medical practice. Thus, the evaluation result of the element “patient consciousness” and the evaluation result of the element “possibility of removal of equipment” are considered in combination. The information corresponding to the item “stage 3” is the third item to be considered in order to determine the rank, and should be considered from the viewpoint of preventing patient-induced accidents (patient safety) that may occur in daily life. Combine the evaluation result of the element “living independence (moving etc.)”, the evaluation result of the element “falling and falling”, the evaluation result of the element “staff to be able to transmit instructions”, and the evaluation result of the element “frequency of drought” Configured to take into account. The information corresponding to the item “rank” is each category when the needs of each element are evaluated into a plurality of categories, and is the same as the information corresponding to the item “rank” in the bed function evaluation table of FIG. However, the first bed condition determination table includes only three ranks 1 to 3. On the side of each rank, characters summarizing the distance from the staff station specified by each rank are shown. “Near” indicates “correspondence near the staff station”, “ “Middle” corresponds to “correspondence at medium distance from the staff station” in the bed function evaluation table of FIG. 4, and “no restriction” corresponds to “no restriction” in the bed function evaluation table of FIG.

  FIG. 6 illustrates the second bed condition determination table. This second bed condition determination table is configured by associating the item “stage 1”, the item “stage 2”, the item “stage 3”, the item “rank”, and information corresponding to these items with each other. ing. The information corresponding to the item “stage 1” is an evaluation result that should be considered first in order to determine the rank, and is an evaluation result that should be considered from the viewpoint of the degree of observation associated with the provision of medical practice.・ Evaluation result of “Urgent level” and evaluation result of element “Equipment necessary for treatment” are considered in combination. The information corresponding to the item “stage 2” is the second evaluation result to be considered in order to determine the rank, and is the evaluation result to be considered from the viewpoint of preventing the influence on the resident in daily life. The evaluation result of “terminal” and the evaluation result of element “infection” are considered in combination. The information corresponding to the item “Stage 3” is the third item to be considered in order to determine the rank, and should be considered from the viewpoint of preventing the influence on residents in daily life. "Effects on patients (including problematic behaviors)" and the evaluation results of the element "family attendance (at lodging)" are considered in combination. The information corresponding to the item “rank” is each category when the needs of each element are evaluated into a plurality of categories, and is the same as the information corresponding to the item “rank” in the bed function evaluation table of FIG. The second bed condition determination table includes four ranks A to 3. On the side of each rank, the number of beds in the room specified by each rank / characters summarizing the specific rooms are shown, and “specific” indicates “specific function rooms” and “private rooms” in the bed function evaluation table of FIG. "Is required for private room" in the bed function evaluation table of FIG. 4, "desirable for single room" is "preferable for single room" in the bed function evaluation table of FIG. 4, and "large room" is in the bed function evaluation table of FIG. Corresponding to "Available in large rooms" respectively.

  FIG. 7 illustrates a third bed condition determination table. The third bed condition determination table is configured by associating an item “precondition” and an item “stage 1” with information corresponding to each item. The information corresponding to the item “precondition” is an evaluation result to be considered first in order to determine the rank, and is an evaluation result that is a precondition for determining the rank, and the element “severity / emergency” The evaluation result of “degree”, the element “possibility of state deterioration”, the element “patient consciousness”, and the evaluation result of the element “life independence (movement, etc.)” are considered in combination. Here, the precondition is not the “stage”, because it may not be necessary to consider the rank for determining the distance to the toilet depending on the combination of these evaluation results. This is because it can be considered as a precondition for determination. Specifically, depending on the combination of the evaluation result of the element “severity / emergency” and the evaluation result of the element “possibility of state deterioration”, the rank in the first bed condition determination table of FIG. Since it is determined that the “response near the staff station” is to be performed, it is not necessary to consider the distance determination to the toilet. Alternatively, when it can be determined from the evaluation result of the element “patient consciousness” and the evaluation result of the element “living independence” that the patient can go to the toilet without any problem, there is no need to consider the determination of the distance to the toilet. Therefore, the rank corresponding to these cases was set to “− (no need for consideration) (the result is equivalent to“ no constraint ”in rank 3)”. The information corresponding to the item “Stage 1” is an evaluation result to be considered second in order to determine the rank, and is an evaluation result to be considered from the viewpoint of prevention of patient-induced accidents (patient safety) associated with the use of living facilities. The evaluation result of the element “excretion place”, the evaluation result of the element “moving means to the toilet”, the evaluation result of the element “physical strength”, the evaluation result of the element “sight”, and the element “frequency (frequency of excretion)” It is configured to consider the evaluation results in combination. The information corresponding to the item “rank” is each category when the needs of each element are evaluated into a plurality of categories, and is the same as the information corresponding to the item “rank” in the bed function evaluation table of FIG. This third bed condition determination table includes only three ranks 1 to 3. On the side of each rank, characters summarizing the distance to the toilet specified by each rank are shown, and “Near” indicates “Responding near the toilet” and “Medium” in the bed function evaluation table of FIG. 4 corresponds to “no restriction” in the bed function evaluation table of FIG. 4, and “no restriction” corresponds to “no restriction” in the bed function evaluation table of FIG.

  Each of the tables shown in FIGS. 5 to 7 extracts the elements that need to be considered according to the purpose of each table among the elements included in the patient attribute needs evaluation table shown in FIG. Evaluation results of the extracted elements (ie, evaluation results for multiple patient attribute needs regarding patients who are hospitalized and receive medical services in one of multiple hospital beds), and the rank determined according to the combination of these evaluation results (That is, bed conditions that should be possessed by a bed suitable for a patient's medical service) and information (bed condition determination information) that are associated with each other.

  In particular, the tables shown in FIGS. 5 to 7 are created according to different purposes, and at least a part of the evaluation results are different from each other and the bed conditions are different from each other. Thus, by preparing different tables according to the purpose, it becomes possible to specify the bed condition according to the purpose.

  In particular, in each table shown in FIGS. 5 to 7, the evaluation results of each element are arranged in order from the highest priority to be considered. For example, in the second bed condition determination table of FIG. 6, in stage 1, it is most important to consider the viewpoint of the degree of observation accompanying the provision of medical practice. Consider the “urgency” and the element “equipment necessary for treatment”. Of these, it is most important to consider the factor “severity / emergency”. Based on the evaluation result of the element “severity / emergency”, the number of beds / rank of specific rooms is in a certain range. Based on the evaluation result of the element “equipment necessary for treatment”, the number of beds / the rank of the specific room is further narrowed down within the certain range. Next, since it is important to consider the viewpoint of preventing the influence on the resident in daily life, the element “terminal” and the element “infection” are considered as elements related to this viewpoint. Among these, since it is important to consider the element “terminal” from the viewpoint of patient privacy, based on the evaluation result of this element “terminal”, the number of beds narrowed down in stage 1 / range of ranks of specific rooms In addition, the number of beds / specific room rank is further narrowed down to a certain range, and then the number of beds / specific room rank is further reduced within the certain range based on the evaluation result of the element “infection”. Narrow down. Finally, in order to finally consider the viewpoint of preventing the impact on residents in daily life, the elements “effects on other patients (including problem behavior)” and element “family attendance (accommodation) ) ”. Among these, it is more important to consider the factor “effects on other patients (including problem behavior)”, so based on the evaluation results of this element “effects on other patients (including problem behavior)” Within the range of the number of beds / specific rooms ranked in stage 2, the number of beds / specific rooms is further narrowed to a certain range, and then the evaluation result of the element “family attendance (at lodging)” Based on the above, the number of beds / the rank of a specific room is finally narrowed down to one within the certain range. By configuring each table according to the order of viewpoints and elements that are important to consider, it is possible to determine a rank that matches the importance of viewpoints and elements.

(Constitution)
Next, the configuration of the bed management support system according to the present embodiment constructed based on the above examination results will be described. FIG. 8 is a block diagram illustrating a functional concept of the bed management support system according to the present embodiment. As shown in FIG. 8, the bed management support system 1 includes an input unit 10, an output unit 20, a control unit 30, and a storage unit 40.

(Configuration-input part)
The input unit 10 is an information input unit that receives input of information necessary for providing support for hospital beds. As this input part 10, input means, such as a well-known keyboard, a mouse | mouth, a touch panel, can be used, for example. Details of various types of information that the input unit 10 receives input will be described later.

(Configuration-output part)
The output unit 20 is an output unit that outputs information necessary for providing support for a hospital bed. For example, a known flat panel display such as a liquid crystal display or an organic EL display can be used.

(Configuration-control unit)
The control unit 30 is a control means for controlling the hospital bed management support system 1, and specifically, a CPU, various programs interpreted and executed on the CPU (a basic control program such as an OS, and started on the OS). And an internal memory such as a RAM for storing the program and various data. In particular, the bed management support program according to the present embodiment is installed in the bed management support system 1 via an arbitrary recording medium or network, thereby substantially configuring each unit of the control unit 30.

  The control unit 30 includes a bed condition specifying unit 31 and a bed specifying unit 32 in terms of functional concept. When the evaluation result for a plurality of attributes or a plurality of needs of a patient is specified by a predetermined method, the bed condition specifying unit 31 stores the bed conditions corresponding to the specified evaluation result in the storage unit 40. This is bed condition specifying means for specifying with reference to a bed condition determination table to be described later. The bed specifying unit 32 refers to a bed management table, which will be described later, stored in the storage unit 40 as a bed that satisfies the bed condition specified by the bed condition specifying unit 31 as a bed suitable for the patient's medical service. It is a bed identification means to identify. Details of processing executed by each component of the control unit 30 will be described later.

(Configuration-storage unit)
The storage unit 40 is a storage unit that stores a program and various data necessary for the operation of the bed management support system 1, and is configured using, for example, a hard disk (not shown) as an external storage device. However, any other recording medium including a magnetic recording medium such as a magnetic disk or an optical recording medium such as a DVD or a Blu-ray disk can be used instead of or together with the hard disk.

  The storage unit 40 includes a patient attribute need evaluation table shown in FIG. 2, a bed function evaluation table shown in FIG. 4, a first bed condition determination table shown in FIG. 5, and a second bed condition determination shown in FIG. The table, the third bed condition determination table shown in FIG. 7, and the bed management table described later are stored. Since these first to third bed condition determination tables are bed condition determination information as described above, the storage unit 40 is a bed condition determination information storage unit that stores bed condition determination information.

  The bed management table includes a plurality of beds arranged in one specific hospital that is a target of bed management support by the bed management support system 1 and bed conditions that each of the plurality of bed satisfies. It is the bed management information configured in association with. That is, the storage unit 40 is a bed management information storage unit that stores bed management information. FIG. 9 illustrates a bed management table. This bed management table stores an item “bed ID”, an item “bed position”, an item “rank”, and information corresponding to these items in association with each other. Information corresponding to the item “bed ID” is bed identification information for uniquely identifying each bed. Information corresponding to the item “bed position” is information for specifying the position of each bed, and includes, for example, a floor number, a room name, and a bed number. The information corresponding to the item “rank” is the same as the information corresponding to the item “rank” in the bed function evaluation table of FIG. The item “rank” includes an item “distance from the staff station”, an item “the number of beds in the room / specific room”, and an item “distance to the toilet”.

(processing)
Next, the bed management support process executed by the bed management support system 1 configured as described above will be described. FIG. 10 is a flowchart of the bed management support process (in the following description of each process, step is abbreviated as “S”). In this bed management support process, for example, after the power to the bed management support system 1 is turned on, an instruction is input from the user (medical person) to execute the bed management support process via the input unit 10. Will be launched.

  After the start of the bed management support process, the bed condition specifying unit 31 waits until an input from the user of evaluation results for a plurality of attributes or a plurality of needs of the patient is received by the input unit 10 (SA1, No). An evaluation result for a plurality of attributes or a plurality of needs is an evaluation result of the above-described attribute needs related to a patient who is a subject of bed determination, and specifically, for each patient attribute item of a patient attribute needs evaluation table. , Any one of the evaluation categories 1 to 4. The method of inputting the evaluation result is arbitrary. For example, the bed condition specifying unit 31 reads out a patient attribute need evaluation table from the storage unit 40, and provides an input field for inputting the evaluation result to the patient attribute need evaluation table. The output unit 20 outputs an input screen having a predetermined format generated by the addition. Then, the user evaluates the patient with respect to each patient attribute item based on the evaluation method of the patient attribute need evaluation table, and inputs the evaluation result to the input screen by any numerical value from the evaluation categories 1 to 4. .

  When an input from the user of evaluation results for a plurality of attributes or needs of a patient is received by the input unit 10 (SA1, Yes), the bed condition specifying unit 31 stores the storage unit 40 based on these evaluation results. The rank of the distance from the staff station is determined by referring to the first bed condition determination table stored in (SA2). For example, the evaluation result accepted in SA1 is the evaluation result of the element “severity / urgent degree” = 2, the evaluation result of the element “possibility of condition deterioration” = 2, and the evaluation result of the element “patient awareness” = 1. , Evaluation result of element “possibility of removal of equipment” = 2, evaluation result of element “life independence (moving, etc.)” = 3, evaluation result of element “falling and falling” = 2, element “whether or not staff can transmit instructions” If the evaluation result is 2 and the evaluation result of the element “frequency of wrinkles” is 3, the rank of the distance from the staff station is determined to be 2 (“medium”). In this case, since the rank is specified based on the evaluation result up to the evaluation result of the element “staff instruction transmission possibility” = 2, the evaluation result of the evaluation result of the element “frequency of wrinkles” = 3 is considered. The determination ends without doing so.

  Next, the bed condition specifying unit 31 refers to the second bed condition determination table stored in the storage unit 40 based on the evaluation result received in SA1, thereby determining the number of beds in the room / the rank of the specific room. Determine (SA3). For example, the evaluation result accepted at SA1 is that the evaluation result of the element “severity / emergency” = 3, the evaluation result of the element “equipment necessary for treatment” = 1, the evaluation result of the element “terminal” = 1, the element Evaluation result of “Infectious disease” = 1, Evaluation result of element “Influence on other patients (including problematic behavior)” = 1, Evaluation result of element “Family attendance (with lodging)” = 1 The number of beds in the room / rank of the specific room = 3 (“large room”).

  Next, the bed condition specifying unit 31 determines the rank of the distance to the toilet by referring to the third bed condition determination table stored in the storage unit 40 based on the evaluation result received in SA1 ( SA4). For example, the evaluation result accepted in SA1 is the evaluation result of the element “severity / urgent degree” = 3, the evaluation result of the element “possibility of state deterioration” = 2, and the evaluation result of the element “patient consciousness” = 2. , Evaluation result of element “life independence (moving, etc.)” = 3, evaluation result of element “excretion place” = 2, evaluation result of element “moving means to toilet” = 3, evaluation result of element “physical fitness” = 1. When the evaluation result of the element “sight” = 1 and the evaluation result of the element “frequency (number of excretion)” = 1, the rank of the distance to the toilet is determined to be 2 (“medium”).

  Thus, the rank of the distance from the staff station determined in SA2, the number of beds in the room / specific room determined in SA3, and the rank of the distance to the toilet determined in SA4 are suitable for patient medical services. The bed conditions that the bed should have are specified.

  Next, the bed specifying unit 32 specifies a bed that satisfies the bed conditions specified by the bed condition specifying unit 31 as a bed suitable for the patient's medical service (SA5). Specifically, the bed specifying unit 32 is based on the rank of the distance from the staff station determined in SA2, the number of beds in the room determined in SA3 / the rank of the specific room, and the rank of the distance to the toilet determined in SA4. Then, by referring to the bed management table stored in the storage unit 40, the bed that matches the combination of these ranks is specified. For example, if the rank of the distance from the staff station determined in SA2 is 1, the number of beds in the room determined in SA3 / rank of the specific room = 2, and the rank of the distance to the toilet determined in SA4 = 2, A hospital bed with a hospital bed ID = ID0001 and a hospital bed position = 2 floor-first hospital room-right window side is identified as a hospital bed suitable for the patient's medical service.

  Then, the bed specifying unit 32 outputs information on the bed specified in this way via the output unit 20 (SA6). For example, the bed specifying unit 32 displays the bed ID and the bed position of the specified bed on the monitor. As a result, the user can grasp the bed suitable for the patient's medical service. This completes the bed management support process.

  If no bed is identified in SA5 (the rank of the distance from the staff station determined in SA2, the number of beds in the room / rank of the specific room determined in SA3, and the distance to the toilet determined in SA4) In the case where there is no bed that matches the combination of ranks), the bed specifying unit 32 sets at least one of these three ranks higher than the rank determined in SA2 to SA4. The rank is changed, and the bed in SA5 is specified based on the rank combination after the change. That is, a bed that matches a rank higher than the necessary rank (overspec rank) is identified as a bed suitable for the patient's medical service. For example, when the rank of the distance from the staff station determined in SA2 is 3, the rank is changed to 2, and the bed in SA5 is specified. In this way, if any one of the ranks is changed to a higher rank by one and the bed is still not identified, the rank can be changed to a higher rank by one or another After changing the rank to one higher rank, the bed in SA5 is specified. Similarly, the rank change and the bed specification in SA5 are repeated until at least one bed is specified. Moreover, when changing the rank in this way, which of the above three ranks is to be changed depends on the viewpoint of maintaining and improving the safety and quality of the medical service for the patient, or the management of the hospital. From the viewpoint of efficiency, priorities are set in advance, and ranks are changed in descending order of priority.

  In addition, when multiple beds are identified in SA5 (rank of the distance from the staff station determined in SA2, the number of beds in the room / determined in SA3, and the rank of the distance to the toilet determined in SA4) If there are two or more beds that match this combination, simply output these multiple beds at SA6, and finally the user will select any bed that will actually accept the patient from the multiple beds. You may make it select on the basis of these. Alternatively, in this case, the bed specifying unit 32 may perform a process of specifying one bed from the plurality of beds. For example, the rank change and the specification of the bed in SA5 may be repeated until one bed can be specified by the same method as described above.

(Modification)
Although the embodiments of the present invention have been described above, the specific configuration and means of the present invention can be arbitrarily modified and improved within the scope of the technical idea of each invention described in the claims. Can do. Hereinafter, such a modification will be described.

(About problems to be solved and effects of the invention)
First, the problems to be solved by the invention and the effects of the invention are not limited to the above contents, and may vary depending on the implementation environment and details of the configuration of the invention. May be solved, or only some of the effects described above may be achieved.

(About distribution and integration)
Further, each of the electrical components described above is functionally conceptual and does not necessarily need to be physically configured as illustrated. That is, the specific form of distribution or integration of each part is not limited to the one shown in the figure, and all or a part thereof is functionally or physically distributed or integrated in arbitrary units according to various loads or usage conditions. Can be configured. For example, when the beds of a plurality of hospitals are managed in an integrated manner, the bed management support system 1 is arranged in the central management center, and the beds of the plurality of hospitals are covered in the storage unit 40 of the bed management support system 1. The hospital bed management table is stored. When an evaluation result is input by a user at a terminal device arranged in each hospital, the evaluation result is transmitted to the bed management support system 1 via a network such as the Internet, and the bed management support system 1 uses the bed condition. It is also possible to identify a hospital bed and transmit this identification result to a terminal device via a network and output it to the user at this terminal device. Further, the bed management support system 1 may be separated into a plurality of computer devices. Considering the possibility of such separation, the mechanism that supports bed management is expressed as "system", but it is configured as a bed management support device by having all functions in a single computer device. Also good.

(Specification of bed conditions and identification of bed)
In the above-described embodiment, the process up to the specification of the bed is automatically performed, but the process up to the specification of the bed condition may be automatically performed and output, and the subsequent bed may be specified by the user.

(About bed condition judgment table)
In the above embodiment, three bed condition determination tables from the first to the third are used as the bed condition determination table. However, only some of the tables may be used, or a plurality of these tables may be used as one table. It may be integrated into.

DESCRIPTION OF SYMBOLS 1 Bed management support system 10 Input unit 20 Output unit 30 Control unit 31 Bed condition specifying unit 32 Bed specifying unit 40 Storage unit

Claims (3)

A bed management support system for supporting the management of a plurality of beds in a hospital,
Evaluation results for a plurality of attributes or a plurality of needs regarding a patient who is admitted to the hospital and receives medical services in any of the plurality of beds, and bed conditions that should be possessed by a bed suitable for the patient's medical services, Bed condition determination information storage means for storing bed condition determination information configured in association with each other;
Bed management information storage means for storing bed management information configured by associating the plurality of beds and the bed conditions satisfied by each of the plurality of beds,
When an evaluation result for a plurality of attributes or a plurality of needs of the patient is specified by a predetermined method, a bed condition corresponding to the specified evaluation result is stored in the bed condition determination information storage unit. Bed condition specifying means for specifying with reference to condition determination information;
A bed satisfying the bed condition specified by the bed condition specifying unit is specified as a bed suitable for the medical service of the patient with reference to the bed management information stored in the bed management information storage unit. A bed specifying means,
The bed condition determination information storage means includes:
A plurality of bed condition determination information corresponding to each of the plurality of functional items of the bed, wherein a plurality of bed condition determination information in which at least some of the evaluation results are different from each other and the bed conditions are different from each other is stored. And
The bed condition specifying means includes
A plurality of bed conditions corresponding to the specified evaluation results are specified with reference to each of the plurality of bed condition determination information stored in the bed condition determination information storage means,
The bed identifying means is:
With reference to the bed management information stored in the bed management information storage means, it is determined whether there is a bed that satisfies all of the plurality of bed conditions specified by the bed condition specifying means. ,
If it is determined that there is a bed that satisfies all of the plurality of bed conditions, the bed is identified as a bed suitable for the patient's medical service,
When it is determined that there is no bed that satisfies all of the plurality of bed conditions, at least one of the plurality of bed conditions is set based on the priority of the plurality of bed conditions set in advance. Change the rank of the bed condition with high priority to a higher rank, determine whether there is a bed that satisfies all of the changed bed conditions, and then change the plurality of the changed bed conditions Until it is determined that there is a bed that satisfies all of the bed conditions, the change of the plurality of bed conditions and the determination of the presence or absence of the bed are sequentially repeated.
Illness floor management support system. A bed management support method for supporting the management of a plurality of beds in a hospital,
Evaluation results for a plurality of attributes or a plurality of needs regarding a patient who is admitted to the hospital and receives medical services in any of the plurality of beds, and bed conditions that should be possessed by a bed suitable for the patient's medical services, A bed condition determination information storage step of storing the bed condition determination information configured in association with each other in the bed condition determination information storage means of the bed management support system;
Bed management information storage for storing bed management information configured by correlating the plurality of beds and the bed conditions satisfied by each of the plurality of beds in a bed management information storage unit of a bed management support system Steps,
In the bed management support system, when an evaluation result for a plurality of attributes or a plurality of needs of the patient is specified by a predetermined method, a bed condition corresponding to the specified evaluation result is stored in the bed condition determination information storage means. A bed condition specifying step for specifying with reference to the bed condition determination information stored in
A bed that specifies a bed that satisfies the bed condition specified in the bed condition specifying step as a bed suitable for the patient's medical service with reference to the bed management information stored in the bed management information storage means. A specific step,
In the bed condition determination information storage step,
A plurality of bed condition determination information corresponding to each of the plurality of functional items of the bed, wherein a plurality of bed condition determination information in which at least some of the evaluation results are different from each other and the bed conditions are different from each other is stored. And
In the bed condition specifying step,
A plurality of bed conditions corresponding to the specified evaluation results are specified with reference to each of the plurality of bed condition determination information stored in the bed condition determination information storage means,
In the hospital bed identification step,
While referring to the bed management information stored in the bed management information storage means, determine whether there is a bed that satisfies all of the plurality of bed conditions specified in the bed condition specifying step,
If it is determined that there is a bed that satisfies all of the plurality of bed conditions, the bed is identified as a bed suitable for the patient's medical service,
When it is determined that there is no bed that satisfies all of the plurality of bed conditions, at least one of the plurality of bed conditions is set based on the priority of the plurality of bed conditions set in advance. Change the rank of the bed condition with high priority to a higher rank, determine whether there is a bed that satisfies all of the changed bed conditions, and then change the plurality of the changed bed conditions Until it is determined that there is a bed that satisfies all of the bed conditions, the change of the plurality of bed conditions and the determination of the presence or absence of the bed are sequentially repeated.
Hospital bed management support method. A bed management support program for causing a computer to execute the method according to claim 2.

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