Wimble Katie, Yeong Keefai
Ashford and St Peters NHS Foundation Trust.
BMJ Qual Improv Rep. 2012 Oct 24;1(1). doi: 10.1136/bmjquality.u474.w148. eCollection 2012.
Follow-up is a vital part of ongoing patient safety. It allows for subsequent investigations to be checked and acted upon, encourages specialist review of patients and ensures that patients with chronic conditions receive the appropriate secondary care input. This study aims to highlight and quantify current problems with how follow-up arrangements are made within our hospital and provide a suitable solution to ensure that these problems are minimised. 20 sets of clinical notes were analysed for plans of follow-up and then compared with the discharge summaries produced. Hospital computer systems were used to find out which interventions happened, and when, to get the baseline data. A simple follow-up prompt sheet was introduced and a further 20 sets of notes were audited to complete the study. Patient follow-up improved after the introduction of a simple follow-up prompt sheet but highlighted the need for a complete change in the way follow up is arranged at our hospital. There is a need for an online system for requesting follow-up appointments in our hospital. This is vital given the 24 hour environment that we work in with many patients being discharged out of normal working hours. This is currently being discussed with management and we hope that the introduction will be imminent to improve the future safety of all patients.
随访是持续保障患者安全的重要组成部分。它能对后续调查进行检查并采取相应行动,促使对患者进行专科评估,并确保慢性病患者获得适当的二级护理。本研究旨在突出并量化我院目前在随访安排方面存在的问题,并提供一个合适的解决方案,以确保将这些问题降至最低。分析了20套临床记录中的随访计划,然后与出院小结进行比较。利用医院计算机系统查明发生了哪些干预措施以及何时发生,以获取基线数据。引入了一份简单的随访提示表,并对另外20套记录进行审核以完成研究。引入简单的随访提示表后患者随访情况有所改善,但凸显出我院安排随访方式需要彻底改变。我院需要一个在线系统来预约随访。鉴于我们所处的24小时工作环境,许多患者在正常工作时间之外出院,这一点至关重要。目前正在与管理层讨论此事,我们希望该系统能尽快引入,以提高所有患者未来的安全性。