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共置围产期精神病学诊所:增加心理学家对临床质量改进指标的影响。

Co-located perinatal psychiatry clinic: impact of adding a psychologist on clinical quality improvement metrics.

机构信息

a Medical College of Wisconsin, Psychiatry , Milwaukee , WI , USA.

b University of Wisconsin Milwaukee, Zilber School of Public Health , Milwaukee , WI , USA.

出版信息

J Psychosom Obstet Gynaecol. 2019 Jun;40(2):123-127. doi: 10.1080/0167482X.2018.1442825. Epub 2018 Mar 2.

Abstract

To describe the impact of adding a psychologist (the intervention) to a co-located perinatal psychiatry clinic (PPC) in terms of effects on clinical quality improvement (QI) metrics. Six-month pre- and postintervention study design with measurement of QI metrics: number of unique patients treated; number of new and established visits; percent no-shows for new and established visits; and mean wait time to new visit. Number of unique patients treated by the psychiatrist increased by 30%, from 90 preintervention to 118 postintervention ( = .06). Total number of visits completed by the psychiatrist increased by 20% from 174 preintervention to 208 postintervention. Mean wait time for new visits for a physician decreased from 20 days preintervention to 14 days postintervention, with a mean difference of 6.4 days ( = .0015). Percentage of no-shows for new visits increased slightly from 23% preintervention to 26% postintervention ( = .72). The percentage of no-shows for established visits decreased significantly from 22% preintervention to 10% postintervention ( < .005). By adding a psychologist to the co-located PPC, we improved quality of perinatal mental health care by improving efficiency, timeliness and patient-centered care. The psychiatrist saw a greater number of unique patients, decreased wait time to new visits and decreased no-show rates for established visits, likely by better matching patient needs with provider services. A psychologist could be a valuable addition to a PPC, given the shortage of psychiatrists in the United States.

摘要

描述在位于同一地点的围产期精神病学诊所(PPC)中增加心理学家(干预措施)对临床质量改进(QI)指标的影响。采用 6 个月的干预前后研究设计,测量 QI 指标:治疗的独特患者人数;新诊和复诊的数量;新诊和复诊的失约率;以及新诊的平均等待时间。精神病医生治疗的独特患者人数增加了 30%,从干预前的 90 人增加到干预后的 118 人( = .06)。精神病医生完成的总就诊次数增加了 20%,从干预前的 174 次增加到干预后的 208 次。新就诊的平均等待时间从干预前的 20 天减少到干预后的 14 天,平均差异为 6.4 天( = .0015)。新就诊的失约率略有上升,从干预前的 23%上升到干预后的 26%( = .72)。复诊的失约率显著下降,从干预前的 22%下降到干预后的 10%( < .005)。通过在位于同一地点的 PPC 中增加心理学家,我们通过提高效率、及时性和以患者为中心的护理来改善围产期心理健康护理的质量。精神病医生看了更多的独特患者,减少了新就诊的等待时间,并减少了复诊的失约率,这可能是通过更好地将患者的需求与提供者的服务相匹配。鉴于美国精神病医生短缺,心理学家可以成为 PPC 的有价值的补充。

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Non-psychotic mental disorders in the perinatal period.围生期非精神病性精神障碍。
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