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儿童门诊日间手术:患者及医护人员视角

Clinic-day surgery for children: a patient and staff perspective.

作者信息

Criss Cory N, Brown Johnathan, Gish Joshua S, Gadepalli Samir K, Hirschl Ronald B

机构信息

Section of Pediatric Surgery, Department of Surgery, Michigan Medicine, C.S. Mott Children's Hospital, Ann Arbor, MI, 48109, USA.

University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA.

出版信息

Pediatr Surg Int. 2018 Jul;34(7):755-761. doi: 10.1007/s00383-018-4288-3. Epub 2018 May 28.

Abstract

INTRODUCTION

For the past 3 years, our institution has implemented a same clinic-day surgery (CDS) program, where common surgical procedures are performed the same day as the initial clinic evaluation. We sought to evaluate the patient and faculty/staff satisfaction following the implementation of this program.

METHODS

After IRB approval, patients presenting for the CDS between 2014 and 2017 were retrospectively reviewed. Of these, patient families who received CDS were contacted to perform a telephone survey focusing on their overall satisfaction and to obtain feedback. In addition, feedback from faculty/staff members directly involved in the program was obtained to determine barriers and satisfaction with the program.

RESULTS

Twenty-nine patients received CDS, with the most commonly performed procedures being inguinal hernia repair (34%) and umbilical hernia repair (24%). Twenty (69%) patients agreed to perform the telephone survey. Parents were overall satisfied with the CDS program, agreeing that the instructions were easy to understand. Overall, 79% of parents indicated that it decreased overall stress/anxiety, with 75% saying it allowed for less time away from work, and 95% agreeing to pursue CDS again if offered. The most common negative feedback was an unspecified operative start time (15%). While faculty/staff members agreed the program was patient-centered, there were concerns over low enrollment and surgeon continuity, because there were different evaluating and operating surgeons.

CONCLUSION

This study successfully evaluated the satisfaction of patients and faculty/staff members after implementing a clinic-day surgery program. Our results demonstrated improved patient family satisfaction, with families reporting decreased anxiety and less time away from work. Despite this, faculty and staff members reported challenges with enrollment and surgeon continuity.

摘要

引言

在过去三年里,我们机构实施了一项同日门诊手术(CDS)计划,即常见外科手术在初次门诊评估的同一天进行。我们试图评估该计划实施后患者以及教职员工的满意度。

方法

经机构审查委员会(IRB)批准后,对2014年至2017年间接受同日门诊手术的患者进行回顾性研究。其中,联系了接受同日门诊手术患者的家属,进行电话调查,重点了解他们的总体满意度并获取反馈。此外,还收集了直接参与该计划的教职员工的反馈,以确定该计划的障碍和满意度。

结果

29名患者接受了同日门诊手术,最常进行的手术是腹股沟疝修补术(34%)和脐疝修补术(24%)。20名(69%)患者同意接受电话调查。家长对同日门诊手术计划总体满意,认为说明易于理解。总体而言,79%的家长表示该计划减轻了总体压力/焦虑,75%的家长称这减少了工作时间,95%的家长表示如果有机会愿意再次选择同日门诊手术。最常见的负面反馈是手术开始时间未明确(15%)。虽然教职员工认为该计划以患者为中心,但对低登记率和外科医生的连续性存在担忧,因为评估和手术的外科医生不同。

结论

本研究成功评估了实施同日门诊手术计划后患者及教职员工的满意度。我们的结果表明患者家庭满意度有所提高,家庭报告焦虑减轻且工作时间减少。尽管如此,教职员工报告了登记和外科医生连续性方面的挑战。

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