Ledlow G R, Bradshaw D M, Shockley C
Graduate Faculty, Central Michigan University, Colleges of Extended Learning and Health Professions, Mount Pleasant 48858, USA.
Mil Med. 2000 May;165(5):390-5.
Improving community primary care access is a difficult and dynamic undertaking. Realizing a need to improve appointment availability, a systematic approach based on measurement, empowerment, and interaction was developed. The model fostered exchange of information and problem solving between interdependent staff sections within a managed care system. Measuring appointments demanded but not available proved to be a credible customer-focused approach to benchmark against set goals. Changing the organizational culture to become more sensitive to changing beneficiary needs was a paramount consideration. Dependent-group t tests were performed to compare the pretreatment and posttreatment effect. The empowerment-interaction model significantly improved the availability of routine and wellness-type appointments. The availability of urgent appointments improved but not significantly; a better prospective model needs to be developed. In aggregate, appointments demanded but not available (empowerment-interaction model) were more than 10% before the treatment and less than 3% with the treatment.
改善社区初级医疗服务的可及性是一项艰巨且动态的工作。意识到需要提高预约的可获得性后，开发了一种基于测量、赋权和互动的系统方法。该模型促进了管理式医疗系统中相互依存的员工部门之间的信息交流和问题解决。测量所需但无法获得的预约被证明是一种以客户为中心的可靠方法，可用于对照既定目标进行基准评估。将组织文化转变为对受益人的不断变化的需求更加敏感是一个至关重要的考虑因素。进行了相关样本t检验以比较治疗前和治疗后的效果。赋权 - 互动模型显著提高了常规和健康类预约的可获得性。紧急预约的可获得性有所改善，但不显著；需要开发更好的前瞻性模型。总体而言，所需但无法获得的预约（赋权 - 互动模型）在治疗前超过10%，治疗后不到3%。
