Ruth Jennifer L, Geskey Joseph M, Shaffer Michele L, Bramley Harry P, Paul Ian M
Penn State College of Medicine, Hershey, PA, USA.
Clin Pediatr (Phila). 2011 Oct;50(10):923-8. doi: 10.1177/0009922811407179. Epub 2011 May 16.
To determine the preferences for and satisfaction with communication between pediatric primary care physicians (PCPs) and hospitalists, 2 surveys (PCP and hospitalist versions with matching questions) were developed. Overall, PCPs were less satisfied than hospitalists with communication (P < .01). The 2 provider types had differing opinions on responsibility for care after hospital discharge, with hospitalists more likely than PCPs to assign responsibility to the PCP for pending labs (65% vs 49%; P < .01), adverse events (85% vs 67%; P < .01), or status changes (85% vs 69%; P < .01). Whereas satisfaction with and preferences for patient-related communication differed between hospitalists and PCPs, the incongruent views on the responsibility for care after patient discharge have major implications for safety particularly if poor communication occurs at discharge. Successful transitions from the hospital to primary care require communication between hospitalists and PCPs to be consistent, timely, and informative with responsibility for care discussed at discharge.
为了确定儿科初级保健医生(PCP)与住院医生之间沟通的偏好及满意度,我们开展了两项调查(PCP版和住院医生版,问题匹配)。总体而言,PCP对沟通的满意度低于住院医生(P < 0.01)。这两种医疗服务提供者类型在出院后护理责任方面存在不同意见,住院医生比PCP更倾向于将待检实验室结果(65%对49%;P < 0.01)、不良事件(85%对67%;P < 0.01)或病情变化(85%对69%;P < 0.01)的护理责任分配给PCP。虽然住院医生和PCP对与患者相关沟通的满意度及偏好有所不同,但在患者出院后护理责任方面的不一致观点对安全性有重大影响,尤其是在出院时沟通不畅的情况下。从医院到初级保健的成功过渡需要住院医生和PCP之间的沟通保持一致、及时且信息充分,并在出院时讨论护理责任。