Joseph C, Morrissey D, Abdur-Rahman M, Hussenbux A, Barton C
Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK; Clinical Research Centre for Movement Disorders and Gait, Southern Health Centre, Victoria, Australia.
Centre for Sports and Exercise Medicine, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London, UK; Physiotherapy Department, Bart's Health NHS trust, London, UK.
Physiotherapy. 2014 Dec;100(4):277-89. doi: 10.1016/j.physio.2014.03.007. Epub 2014 Apr 16.
Triage is implemented in healthcare settings to optimise access to appropriate care and manage waiting times.
To determine the optimum features of triage systems for patients with musculoskeletal conditions.
AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, MEDLINE, Cochrane Library, Web of Science and Google Scholar.
Studies that included non-musculoskeletal conditions, concerned patients aged <18 years or were set in emergency departments were excluded.
Study quality was graded using the Downs and Black quality index. Qualitative methods were used to further inform the findings of the literature review.
Thirty-four studies met the inclusion criteria, with study quality ranging from eight to 24 out of a possible 27. Musculoskeletal triage is conducted via face-to-face consultation, paper referral letter or telephone consultation. Triage performed by physiotherapists, general practitioners, multidisciplinary teams, nurses, occupational therapists and speech therapists has been shown to be effective using a range of outcomes. Qualitative data revealed the value of supportive interdisciplinary teams, and suggested that this support is more important than choice of clinician. Patients trusted, and expressed preferences for, experienced clinicians to perform triage.
Triage can be performed effectively via a number of methods and by a range of clinicians. Satisfaction, cost, diagnostic agreement, appropriateness of referral and waiting list time have been improved though triage. Multidisciplinary support mechanisms are critical elements of successful triage systems. Patients are more concerned with access issues than professional boundaries.
在医疗环境中实施分诊以优化获得适当护理的机会并管理等待时间。
确定针对肌肉骨骼疾病患者的分诊系统的最佳特征。
AME D、BNI、CINAHL、EMBASE、健康商业精英数据库、卫生管理信息库、MEDLINE、Cochrane图书馆、科学网和谷歌学术。
排除包括非肌肉骨骼疾病、涉及18岁以下患者或在急诊科进行的研究。
使用唐斯和布莱克质量指数对研究质量进行分级。采用定性方法进一步了解文献综述的结果。
34项研究符合纳入标准，研究质量在可能的27分中从8分到24分不等。肌肉骨骼分诊通过面对面咨询、纸质转诊信或电话咨询进行。物理治疗师、全科医生、多学科团队、护士、职业治疗师和言语治疗师进行的分诊已被证明在一系列结果方面是有效的。定性数据揭示了支持性跨学科团队的价值，并表明这种支持比临床医生的选择更重要。患者信任并表示希望由经验丰富的临床医生进行分诊。
分诊可以通过多种方法并由一系列临床医生有效进行。通过分诊，满意度、成本、诊断一致性、转诊适宜性和等候名单时间都得到了改善。多学科支持机制是成功分诊系统的关键要素。患者更关心获得医疗服务的问题而不是专业界限。
