Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
J Urol. 2013 Nov;190(5):1778-84. doi: 10.1016/j.juro.2013.05.037. Epub 2013 May 23.
Urolithiasis is associated with pain and other health related quality of life decrements. Lack of access to multidisciplinary care is a barrier to prevention. We developed a shared medical appointment to improve access as well as patient education and exposure to multidisciplinary care.
A total of 112 patients (51 ± 14 years, range 19 to 87) were seen in 27 shared medical appointments during 14 months. Patients were seen using existing clinic space, staff and providers. We targeted new patients for the shared medical appointments. We incorporated presentations as well as multidisciplinary rounding in a group setting to provide care for the participants. Patients were surveyed to measure satisfaction as well as knowledge of key prevention concepts.
Appointment wait time decreased steadily from 180±77 days before shared medical appointments to 84±39 days. The number of patients seen per month increased by 43%. The number of new clinic patients, which includes those seen in shared medical appointments and in individual appointments, who received nutrition education and intervention increased from approximately 50% before shared medical appointments to nearly 75%. Patients who attended a shared medical appointment overwhelmingly (87%) rated their satisfaction as excellent or very good; 90% of patients said they would recommend this kind of visit to others. Posttests revealed that patients in shared medical appointments had superior knowledge (p<0.02) than controls.
Shared medical appointments can be an efficient way to evaluate and manage new patients for urolithiasis prevention. Patient satisfaction was high and knowledge about prevention was higher than that of patients seen in individual appointments.
尿石症与疼痛和其他健康相关生活质量下降有关。缺乏多学科护理的机会是预防的障碍。我们开发了一种共享医疗预约，以改善获得途径，以及对患者进行教育和接触多学科护理。
在 14 个月期间，共进行了 27 次共享医疗预约，有 112 名患者（51±14 岁，范围 19 至 87 岁）参加。患者使用现有的诊所空间、工作人员和医务人员进行就诊。我们将新患者作为共享医疗预约的目标人群。我们在小组环境中结合演示以及多学科查房，为参与者提供护理。我们对患者进行了调查，以衡量他们对关键预防概念的满意度和知识水平。
预约等待时间从共享医疗预约前的 180±77 天稳步下降至 84±39 天。每月就诊患者数量增加了 43%。接受营养教育和干预的新诊所患者（包括在共享医疗预约和个别预约中就诊的患者）数量从共享医疗预约前的约 50%增加到近 75%。参加共享医疗预约的患者绝大多数（87%）对他们的满意度评价为优秀或很好；90%的患者表示会向其他人推荐这种就诊方式。后测显示，参加共享医疗预约的患者的知识水平明显高于对照组（p<0.02）。
共享医疗预约可以成为评估和管理尿石症预防新患者的有效方法。患者满意度高，对预防的知识水平高于个别预约就诊的患者。
