Rana Jasmine, Mostaghimi Arash
Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Dermatol Online J. 2017 May 15;23(5):13030/qt0w337137.
Dermatology residents perform consults on hospitalized patients, but are often limited in their ability to follow-up with these patients after discharge, leading to inadequate follow-up and understanding of post-discharge transitions of care. In 2013, a discharge continuity clinic (DCC) staffed by the inpatient consult dermatology resident and attending dermatologist was established at one of the four adult hospital sites residents rotate through in the Harvard Combined Dermatology Residency Program. Resident perceptions about the DCC and their educational experience on inpatient consult rotations with a DCC and without a DCC were obtained using a cross-sectional survey instrument in June 2016. Self-reported data from a multi-year cohort of dermatology residents (n = 14 of 20, 70% response rate) reveals that the DCC enabled resident autonomy and resident satisfaction in care of their patients,insight into the disease-related challenges and the broader social context during transitions of care from inpatient to outpatient settings, and more enriching learning experiences than inpatient consult rotations without a DCC. Dermatology residents self-report participation in an inpatient consult rotation with aDCC supports their autonomy and achievement of post-discharge transitions-of-care competencies.
皮肤科住院医师会对住院患者进行会诊，但他们在患者出院后对其进行随访的能力往往有限，导致随访不足，对出院后护理过渡情况的了解不够。2013年，在哈佛联合皮肤科住院医师培训项目中，住院医师轮转的四个成人医院站点之一设立了由住院会诊皮肤科住院医师和皮肤科主治医生组成的出院连续性诊所（DCC）。2016年6月，通过横断面调查工具，了解了住院医师对DCC的看法以及他们在有DCC和无DCC情况下的住院会诊轮转教育经历。来自多年皮肤科住院医师队列（20人中有14人，回复率70%）的自我报告数据显示，DCC使住院医师在照顾患者方面拥有自主权和满意度，使他们在从住院到门诊护理过渡期间洞察与疾病相关的挑战和更广泛的社会背景，并且比没有DCC的住院会诊轮转提供了更丰富的学习体验。皮肤科住院医师自我报告参与有DCC的住院会诊轮转，这支持了他们的自主权以及出院后护理过渡能力的实现。
