Day J L, Johnson P, Rayman G, Walker R
Diabetes Centre, Ipswich Hospital, Ispwich, Suffolk, UK.
Diabet Med. 1988 Jan;5(1):70-5. doi: 10.1111/j.1464-5491.1988.tb00945.x.
A new system of clinical and educational care designed to replace traditional diabetic clinics is described. The overall aims were to provide adequate consultation time, patient access according to diabetic and social needs, minimal waiting time, continuity with experienced staff and objective based learning programmes in an environment suited to learning. This was achieved by changing the role of the diabetes nurse specialist from undertaking delegated tasks to providing primary consultative care, reorganization of existing staff and provision of a purpose designed unit. This gave sufficient flexibility to arrange daily early morning and weekly evening clinic sessions for routine diabetes counselling and medical audit with primary education scheduled at other times. A year's experience showed that our major targets had been met, with the provision of adequate consultation time, halving of waiting time, ease of patient access and continuity with either the doctor or nurse in consulting role. Default rates have fallen and patient and staff morale has improved substantially. Apart from an underestimate of receptionist and a small increase in technician hours, these changes have been achieved within the predicted small revenue cost.
本文介绍了一种旨在取代传统糖尿病诊所的临床与教育护理新体系。总体目标是在适合学习的环境中，提供充足的咨询时间、根据糖尿病患者及社会需求安排就诊机会、尽量减少等待时间、由经验丰富的工作人员提供连续护理以及开展基于目标的学习项目。这是通过将糖尿病专科护士的角色从执行分配任务转变为提供初级咨询护理、重组现有工作人员以及提供专门设计的单元来实现的。这带来了足够的灵活性，可安排每日清晨和每周晚间门诊进行常规糖尿病咨询和医疗审核，同时将初级教育安排在其他时间。一年的经验表明，我们的主要目标已经实现，提供了充足的咨询时间，等待时间减半，患者就诊便利，并且在咨询过程中能与医生或护士保持连续性。失约率下降，患者和工作人员的士气大幅提高。除了对接待员的估计不足以及技术员工作时长略有增加外，这些改变在预计的小笔收入成本范围内得以实现。
