Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, United States.
Gen Hosp Psychiatry. 2018 Mar-Apr;51:130-131. doi: 10.1016/j.genhosppsych.2017.10.008. Epub 2017 Oct 31.
This letter to the editor describes how psychiatry residents' confidence in delivering population based care improved after working within a collaborative care system.
An anonymous online survey was delivered to 24 psychiatry residents who matriculated through Cambridge Health Alliance residency from 2012 to 2014 and participated in the collaborative care rotation. During the rotation, residents provided direct and indirect consultations, used measurement-based care (MBC) and took a population approach to patient management. Items were asked about residents' level of confidence.
Twenty of 24 residents responded to the survey (83% response rate) with no questions skipped. Among respondents, 80% were confident in the stepped care model, 65% were confident using MBC, 95% were confident communicating and coordinating with primary care teams, 65% felt they were likely to initiate lab checks (such as metabolic monitoring), and 95% had confidence the rotation helped clarify their role as a consultant to primary care teams. Only 30% were confident in providing indirect consultations to primary care teams.
After a 6month rotation in a collaborative care model, psychiatry residents have gained confidence in multiple domains of integrated care. However, additional curriculum development and training is required to help residents improve confidence in indirect consultations.
这封给编辑的信描述了精神病学住院医师在协作式护理系统中工作后，如何提高提供基于人群的护理的信心。
向 2012 年至 2014 年在剑桥健康联盟住院医师培训中参与协作式护理轮转的 24 名精神病学住院医师发送了匿名在线调查。在轮转期间，住院医师提供直接和间接咨询，使用基于测量的护理（MBC）并采用人群方法进行患者管理。询问了有关住院医师信心水平的项目。
24 名住院医师中有 20 名（83%的回复率）回答了调查，没有跳过任何问题。在回答者中，80%对阶梯式护理模式有信心，65%对使用 MBC 有信心，95%对与初级保健团队沟通和协调有信心，65%认为他们可能会启动实验室检查（如代谢监测），95%对轮转有助于澄清他们作为初级保健团队顾问的角色有信心。只有 30%对向初级保健团队提供间接咨询有信心。
在协作式护理模式下进行了 6 个月的轮转后，精神病学住院医师在综合护理的多个领域都增强了信心。然而，需要进一步的课程开发和培训，以帮助住院医师提高对间接咨询的信心。
