Wood Rebecca, Wand Anne P F
Int J Health Care Qual Assur. 2014;27(7):633-41. doi: 10.1108/ijhcqa-02-2014-0019.
Consultation-liaison psychiatry (CLP) researchers have not yet developed accepted quality indicators to measure efficiency or effectiveness. The purpose of this paper is to combine objective and subjective quality indicators to assess hospital-based CLP service utilisation, efficiency and effectiveness.
DESIGN/METHODOLOGY/APPROACH: Service utilisation rate was calculated over the service's first four years. Patient characteristics and objective quality indicators relating to response timeliness in 2012 were examined. Totally, 41 staff and 52 consecutive patients completed evaluation surveys to subjectively evaluate effectiveness.
The utilisation rate increased initially and then slightly declined to 1.03 per cent of all hospital admissions. In 2012, 91.5 per cent were seen on the same referral day and 99.4 per cent by the next day. The benchmark for urgent referrals was not met (77.4 per cent). Patients rated involvement with the CLP service a positive experience (90 per cent), but were less clear about follow-up plans (68 per cent). Staff believed that the service improved the patients' hospital course (98 per cent) and was communicated well (93-95 per cent). Only 63 per cent agreed that relevant CLP education was provided and 76 per cent rated follow-up plans as clear.
ORIGINALITY/VALUE: This CLP service was evaluated by measuring utilisation rates, referral response timeliness and consumer feedback. Referral to contact time is a useful objective quality indicator but should be combined with subjective yet standardised measures surveying service recipients (patients and referring staff) to be comprehensive and meaningful.
会诊联络精神病学(CLP)研究人员尚未制定出被广泛认可的用于衡量效率或效果的质量指标。本文旨在结合客观和主观质量指标,以评估基于医院的CLP服务的利用率、效率和效果。
设计/方法/途径:计算了该服务头四年的利用率。研究了2012年患者的特征以及与响应及时性相关的客观质量指标。共有41名工作人员和52名连续就诊的患者完成了评估调查,以主观评估效果。
利用率最初有所上升,随后略有下降,降至所有住院患者的1.03%。2012年,91.5%的患者在转诊当天得到诊治,99.4%的患者在第二天得到诊治。未达到紧急转诊的基准(77.4%)。患者对参与CLP服务给予了积极评价(90%),但对后续计划不太清楚(68%)。工作人员认为该服务改善了患者的住院过程(98%),沟通良好(93%-95%)。只有63%的人同意提供了相关的CLP教育,76%的人认为后续计划明确。
原创性/价值:通过测量利用率、转诊响应及时性和消费者反馈对该CLP服务进行了评估。转诊到接触的时间是一个有用的客观质量指标,但应与对服务接受者(患者和转诊工作人员)进行主观但标准化的测量相结合,以使其全面且有意义。