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中风患者的接待员识别与转诊(RECEPTS)研究——一项混合方法研究的方案

Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study - protocol of a mixed methods study.

作者信息

Sheppard James P, Singh Satinder, Jones Janet, Bates Elizabeth, Skelton John, Wiskin Connie, McManus Richard J, Mellor Ruth M

机构信息

Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK.

出版信息

BMC Fam Pract. 2014 May 12;15:91. doi: 10.1186/1471-2296-15-91.

Abstract

BACKGROUND

As the first point of contact for patients and witnesses of stroke, General Practice receptionists can be instrumental in deciding the urgency of clinical contact. Despite the considerable complexity of this task, reception staff are not clinically trained. Minimising the time taken to access thrombolysis is crucial in acute stroke as treatment must be initiated within 4.5 hours of the onset, and the earlier the better, to achieve the best outcomes. Research suggests that patients who first contact their General Practice following the onset of stroke symptoms are less likely to receive thrombolysis, in part due to significant delays within Primary Care.This study therefore aims to understand the role of General Practice receptionists, with particular interest in receptionist's ability to recognise people who may be suffering from a stroke and to handle such patients as a medical emergency.

METHODS

The Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study will be a Primary Care based mixed methods study. 60 General Practices in the West Midlands will be recruited. Each practice will receive 10 unannounced simulated patient telephone calls, after the 10 calls questionnaires will be administered to each receptionist. These will examine the behaviour of receptionists towards patients presenting in Primary Care with stroke symptoms, and their knowledge of stroke symptoms. An embedded qualitative study will use interviews and focus groups to investigate the views of General Practice staff on the receptionists' role in patient referral and whether training in this area would be helpful.

DISCUSSION

The results of the RECEPTS study will have important implications for providers of Primary Care. The study will establish current practice in UK primary care in terms of General Practice receptionists' knowledge of the presentation and appropriate referral of those who may be suffering a stroke. It will highlight training needs and how such training might be best delivered.

摘要

背景

作为中风患者及其目击者的首个接触点,全科医疗接待员在确定临床接触的紧迫性方面发挥着重要作用。尽管这项任务相当复杂,但接待人员并未接受过临床培训。在急性中风中,尽量缩短获得溶栓治疗的时间至关重要,因为治疗必须在发病后4.5小时内开始,且越早越好,以取得最佳治疗效果。研究表明,中风症状发作后首先联系全科医疗的患者接受溶栓治疗的可能性较小,部分原因是初级医疗服务中存在严重延误。因此,本研究旨在了解全科医疗接待员的作用,尤其关注接待员识别可能中风患者并将此类患者作为医疗紧急情况处理的能力。

方法

中风患者接待员识别与转诊(RECEPTS)研究将是一项基于初级医疗服务的混合方法研究。西米德兰兹郡的60家全科医疗机构将被招募。每家机构将接到10次未经通知的模拟患者电话,10次电话后,将向每位接待员发放问卷。这些问卷将调查接待员对初级医疗服务中出现中风症状患者的行为,以及他们对中风症状的了解。一项嵌入式定性研究将通过访谈和焦点小组来调查全科医疗工作人员对接待员在患者转诊中的作用的看法,以及该领域的培训是否会有所帮助。

讨论

RECEPTS研究的结果将对初级医疗服务提供者产生重要影响。该研究将确定英国初级医疗服务中全科医疗接待员对可能中风患者的症状表现及适当转诊的了解情况。它将突出培训需求以及如何最好地提供此类培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ca/4030067/70fd1bdf7338/1471-2296-15-91-1.jpg

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