Stille Christopher J, Frantz Jennifer, Vogel Lawrence C, Lighter Donald
Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Clin Pediatr (Phila). 2009 Jul;48(6):661-73. doi: 10.1177/0009922809332590. Epub 2009 Mar 12.
Build a quality improvement (QI) intervention to improve communication between a children's specialty hospital and referring primary care providers (PCPs).
A network of charitable children's hospitals identified improving communication as a systemwide goal. At one model hospital, we used qualitative telephone interviewing of hospital specialists and staff, and referring PCPs, to characterize the communication system and identify potential improvements. We identified potential high-impact areas through content analysis and developed a QI change package with hospital leadership.
Participants described inconsistent communication, with no systematic identification of PCPs. Families were the typical means of inter-physician communication. Multiple non-PCP referral sources were a major contributor to communication breakdowns. Respondents identified a system for identification and communication with PCPs as an essential first step.
Systems for communication with PCPs are underdeveloped at a children's charitable specialty hospital. Straightforward changes could build an effective system that is generalizable to other hospitals.
构建一项质量改进(QI)干预措施,以改善儿童专科医院与转诊初级保健提供者(PCP)之间的沟通。
一个慈善儿童医院网络将改善沟通确定为全系统目标。在一家示范医院,我们通过对医院专科医生、工作人员以及转诊PCP进行定性电话访谈,来描述沟通系统并确定潜在的改进之处。我们通过内容分析确定了潜在的高影响领域,并与医院领导共同制定了一个QI变革方案。
参与者描述了沟通不一致的情况,且没有对PCP进行系统识别。家庭是医生之间沟通的典型方式。多个非PCP转诊来源是沟通中断的主要原因。受访者认为建立一个识别PCP并与其沟通的系统是至关重要的第一步。
一家儿童慈善专科医院与PCP沟通的系统尚不完善。直接的改变可以构建一个有效的系统,该系统可推广至其他医院。