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在门诊物理治疗服务中,进行特定的及时分诊预约可减少等候名单。

Specific timely appointments for triage reduced waiting lists in an outpatient physiotherapy service.

作者信息

Harding K E, Bottrell J

机构信息

Allied Health Clinical Research Office, Eastern Health, Box Hill, VIC, Australia.

Physiotherapy Department, Maroondah Hospital, Ringwood East, VIC, Australia.

出版信息

Physiotherapy. 2016 Dec;102(4):345-350. doi: 10.1016/j.physio.2015.10.011. Epub 2015 Nov 23.

Abstract

OBJECTIVES

Waiting lists with triage systems are commonly used in outpatient physiotherapy but may not be effective. Could an alternative model of access and triage reduce waiting times over a sustained period with no additional resources?

DESIGN

Observational study comparing retrospective data for 11 months prior to the introduction of a new model of access compared with data for the equivalent 11 months afterwards.

PARTICIPANTS

Patients referred to a physiotherapy outpatient department at an outer metropolitan hospital before (n=721) and after (n=707) the introduction of the new model.

INTERVENTION

A model of access and triage known as 'specific timely appointments for triage' (STAT), in which appointment slots are preserved in advance specifically for new patients based on calculation of average demand.

OUTCOME MEASURES

Time from referral to first assessment, number of appointments per patient, occasions of non-attendance and total length of stay in the service.

RESULTS

Median time from referral to first appointment was 18 days [interquartile range (IQR) 11 to 33 days] in the pre-intervention group, compared with 14 days (IQR 9 to 21 days) in the post-intervention group (P<0.01). The number of physiotherapy appointments also reduced (IQR 2 to 6 vs IQR 1 to 4; P<0.01). There were no changes in non-attendance rates or total time in the service.

CONCLUSION

Waiting time for outpatient physiotherapy was 22% lower in the year following the introduction of the STAT model. While acknowledging the limitations of a pre- and post-measurement design, this model may have potential for reducing waiting times for outpatient physiotherapy without additional resources.

摘要

目的

门诊物理治疗中常用带有分诊系统的等候名单,但可能并不有效。一种替代的就诊和分诊模式能否在不增加额外资源的情况下,持续减少等待时间?

设计

观察性研究,比较引入新就诊模式前11个月的回顾性数据与之后同等11个月的数据。

参与者

在引入新模式之前(n = 721)和之后(n = 707)被转诊至一家大都市郊区医院物理治疗门诊的患者。

干预

一种称为“分诊专用及时预约”(STAT)的就诊和分诊模式,即根据平均需求预先专门为新患者保留预约时段。

结局指标

从转诊到首次评估的时间、每位患者的预约次数、未就诊情况及在该服务中的总停留时间。

结果

干预前组从转诊到首次预约的中位时间为18天[四分位间距(IQR)11至33天],干预后组为14天(IQR 9至21天)(P<0.01)。物理治疗预约次数也减少了(IQR 2至6次对IQR 1至4次;P<0.01)。未就诊率或在该服务中的总时间没有变化。

结论

引入STAT模式后的一年里,门诊物理治疗的等待时间降低了22%。尽管认识到前后测量设计存在局限性,但该模式可能有潜力在不增加额外资源的情况下减少门诊物理治疗的等待时间。

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