Garth Belinda, Temple-Smith Meredith, Clark Malcolm, Hutton Cathy, Deveny Elizabeth, Biezen Ruby, Pirotta Marie
Department of General Practice, University of Melbourne, Victoria, Australia.
Aust Fam Physician. 2013 Apr;42(4):238-43.
General practices are required to have flexible systems to accommodate urgent appointments. Not all patients requesting a same day appointment receive one. There is scant research detailing how requests for same day appointments are managed. Our study examined this issue from the perspective of practice staff.
Twenty practice staff (receptionists, practice managers, general practitioners, practice nurse) from 10 general practices participated in semistructured interviews, which were audiorecorded, transcribed and analysed thematically.
All but three practices set aside appointments for patients requesting a same day appointment. Themes included contradictions between policy and practice and the role of experience in determining urgency. Five types of urgent needs for same day appointments were identified: medical, administrative, therapeutic, logistic and emotional.
Practice policies must make clear roles and responsibilities for all staff managing patient appointments. Aspects of clinic policies and practices could be reviewed to reduce medicolegal risk and additional workload caused by non-medically urgent needs.
一般诊疗机构需要具备灵活的系统来安排紧急预约。并非所有要求当日预约的患者都能如愿。关于如何处理当日预约请求的研究很少。我们的研究从诊疗机构工作人员的角度审视了这个问题。
来自10家一般诊疗机构的20名工作人员(接待员、诊疗机构经理、全科医生、执业护士)参与了半结构化访谈,访谈进行了录音、转录并进行了主题分析。
除了3家诊疗机构外,其他机构都为要求当日预约的患者留出了预约时段。主题包括政策与实践之间的矛盾以及经验在确定紧急程度方面的作用。确定了当日预约的五种紧急需求类型:医疗、行政、治疗、后勤和情感需求。
诊疗机构政策必须明确所有负责管理患者预约的工作人员的角色和职责。可以审查诊所政策和实践的各个方面,以降低医疗法律风险以及由非医疗紧急需求导致的额外工作量。