Smock Carissa, Alemagno Sonia
Case Western Reserve University, 11100 Euclid Avenue MS 6036, Cleveland, OH, 44016, USA.
Kent State University College of Public Health, 326 Lowry Hall, 750 Hilltop Dr, Kent, OH, 44709, USA.
BMC Health Serv Res. 2017 Aug 3;17(1):520. doi: 10.1186/s12913-017-2474-y.
The purpose of this study is to understand health care provider barriers to referring patients to Medical Fitness Center Facilities within an affiliated teaching hospital system using referral of diabetic services as an example. The aims of this study include: (1) to assess health care providers' awareness and use of facilities, (2) to determine barriers to referring patients to facilities, (3) identify current and needed resources and/or changes to increase referral to facilities.
A 20-item electronic survey and requests for semi-structured interviews were administered to hospital system directors and managers (n = 51). Directors and managers instructed physicians and staff to complete the survey and interviews as applicable. Perceived barriers, knowledge, utilization, and referral of patients to Medical Fitness Center Facilities were collected and examined. Descriptive statistics were generated regarding practice characteristics, provider characteristics, and referral.
Of the health care providers surveyed and interviewed (n = 25) 40% indicated verbally suggesting use of facilities, 24% provided a flyer about the facilities. No respondents indicated that they directly referred patients to the facilities. However, 16% referred patients to other locations for physical activity - including their own department's management and prevention services. 20% do not refer to Medical Fitness Center Facilities or any other lifestyle programs/locations. Lack of time (92%) and lack of standard guidelines and operating procedures (88%) are barriers to referral. All respondents indicated a strong ability to refer patients to Medical Fitness Center Facilities if given education about referral programs available as well as standard clinical guidelines and protocol for delivery.
The results of this study indicate that, although few healthcare providers are currently referring patients to Medical Fitness Center Facilities, health care providers with an affiliated Medical Fitness Center Facility not only want clinical standard guidelines, protocol, and training to refer patients to Medical Fitness Center Facilities, but believe they have the ability to increase referral if given these tools. The Medical Fitness Association has a unique opportunity to bridge health care providers to Medical Fitness Center Facilities by developing clinical practice guidelines in cooperation with the American Diabetes Association.
本研究旨在以糖尿病服务转诊为例，了解附属教学医院系统内医疗服务提供者将患者转诊至医疗健身中心设施存在的障碍。本研究的目的包括：（1）评估医疗服务提供者对设施的认知和使用情况；（2）确定将患者转诊至设施的障碍；（3）识别当前及所需的资源和/或变革措施，以增加向设施的转诊。
对医院系统的主任和经理（n = 51）进行了一项包含20个项目的电子调查，并邀请他们参加半结构化访谈。主任和经理指示医生和工作人员在适用时完成调查和访谈。收集并检查了对将患者转诊至医疗健身中心设施的感知障碍、知识、利用率和转诊情况。生成了关于实践特征、提供者特征和转诊的描述性统计数据。
在接受调查和访谈的医疗服务提供者（n = 25）中，40%表示曾口头建议使用设施，24%提供了有关设施的传单。没有受访者表示他们直接将患者转诊至这些设施。然而，并16%将患者转诊至其他进行体育活动的场所，包括他们自己科室的管理和预防服务。20%不将患者转诊至医疗健身中心设施或任何其他生活方式项目/场所。时间不足（92%）和缺乏标准指南及操作程序（88%）是转诊的障碍。所有受访者均表示，如果接受有关可用转诊项目以及标准临床指南和转诊规程的培训，他们有很强的能力将患者转诊至医疗健身中心设施。
本研究结果表明，尽管目前很少有医疗服务提供者将患者转诊至医疗健身中心设施，但拥有附属医疗健身中心设施的医疗服务提供者不仅希望获得将患者转诊至医疗健身中心设施的临床标准指南、规程和培训，而且相信如果获得这些工具，他们有能力增加转诊。医疗健身协会有一个独特的机会，通过与美国糖尿病协会合作制定临床实践指南，将医疗服务提供者与医疗健身中心设施联系起来。
