Davidow Stephen L, Sheth Jignesh, Sixta Constance S, Thomas-Hemak Linda
PCPI, Chicago, Illinois (Mr Davidow); and The Wright Center for Graduate Medical Education, Scranton, Pennsylvania (Drs Sheth, Sixta, and Thomas-Hemak).
J Ambul Care Manage. 2018 Oct/Dec;41(4):240-249. doi: 10.1097/JAC.0000000000000247.
More than 105 million referrals of Medicare beneficiaries to specialists occur annually. Different settings and electronic health records have made care coordination complex. PCPI (formerly American Medical Association-convened Physicians Consortium for Performance Improvement) and The Wright Center for Graduate Medical Education sponsored the Closing the Referral Loop pilot project. Twelve dyads of primary care and specialist physicians sought to improve ambulatory referrals by mapping the referral process, and using care compacts, metrics, and electronic health records. Referrals closed on time increased from 40% to 70%. Clinical questions answered increased from 50% to 75%. Adoption of the change package and lessons from this project may significantly improve ambulatory referral management.
医疗保险受益人每年被转诊至专科医生处的次数超过1.05亿次。不同的医疗环境和电子健康记录使得医疗协调变得复杂。PCPI（前身为美国医学协会召集的医师绩效改进联盟）和赖特研究生医学教育中心发起了“关闭转诊循环”试点项目。12对初级保健医生和专科医生通过梳理转诊流程、使用医疗契约、指标和电子健康记录，力求改善门诊转诊情况。按时完成的转诊比例从40%提高到了70%。得到解答的临床问题比例从50%提高到了75%。采用该变革方案以及借鉴此项目的经验教训可能会显著改善门诊转诊管理。
