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未就诊原因:护士主导诊所的审计结果

Reasons for non-attendance: audit findings from a nurse-led clinic.

作者信息

Wilkinson Jill, Daly Mary

机构信息

Massey University, Wellington, New Zealand.

出版信息

J Prim Health Care. 2012 Mar 1;4(1):39-44.

PMID:22377548
Abstract

BACKGROUND AND CONTEXT

Evidence has shown that non-attendance at clinics occurs for a variety of reasons and impacts negatively on client outcomes and effective use of clinic resources. This paper reports an audit of non-attendance at Care Plus and diabetes clinics undertaken between October 2007 and October 2008, in a large general practice in the Wellington region.

ASSESSMENT OF PROBLEM

A retrospective and prospective audit of the non-attendance rate at nurse-led wellness clinics was completed using the Query Builder function in Medtech32, collecting data from 142 people who did not attend a scheduled appointment.

RESULTS

Thirty-three people were unable to be contacted about their reason for not attending. Of those contacted, 68 did not attend because they were unaware of the appointment, confused regarding the appointment time, or simply forgot. Eighty-four people were aged between 18 and 65 years, yet of those contacted, only four cited work had prevented their attendance at the clinic. Difficulty with transport was reported by only two people.

STRATEGIES FOR IMPROVEMENT

The audit highlighted the importance of administration processes for scheduling routine appointments and reminding patients about appointments. It provided evidence that administrative support for nurse-led clinics is necessary.

LESSONS

Involvement in clinical audit was a new experience for many of the staff and the usefulness of the findings led to more positive views about how audit can be used. The importance of appropriate administrative support was highlighted. Lessons learned for future audits included the importance of a complete data set and consistent use of codes for data entry.

摘要

背景与环境

有证据表明,不前往诊所就诊存在多种原因,这对患者治疗结果及诊所资源的有效利用产生了负面影响。本文报告了对2007年10月至2008年10月期间惠灵顿地区一家大型综合诊所的Care Plus诊所和糖尿病诊所患者未就诊情况的审核。

问题评估

利用Medtech32中的查询生成器功能,对护士主导的健康诊所的未就诊率进行了回顾性和前瞻性审核,收集了142名未按预约就诊患者的数据。

结果

有33人无法联系上以询问其未就诊原因。在能联系上的人中,68人未就诊是因为他们不知道有预约、对预约时间感到困惑或只是单纯忘记了。84人的年龄在18至65岁之间,但在能联系上的人中,只有4人表示工作妨碍了他们前往诊所就诊。只有两人表示交通不便。

改进策略

审核突出了安排常规预约及提醒患者预约的管理流程的重要性。这证明了为护士主导的诊所提供行政支持的必要性。

经验教训

参与临床审核对许多工作人员来说是一次全新的经历,审核结果的实用性让人们对审核的用途有了更积极的看法。突出了适当行政支持的重要性。未来审核的经验教训包括完整数据集的重要性以及数据录入时代码的一致使用。

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