Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden.
Int J Qual Health Care. 2019 Aug 1;31(7):30-36. doi: 10.1093/intqhc/mzy244.
To explore how the See-and-Treat concept can be applied in primary care and its effect on volume and productivity.
An explanatory single-case study design with a mixed methods approach and presented according to the SQUIRE 2.0 guidelines.
A publicly-funded, private primary care provider within the Stockholm County, which caters to a diverse patient population in terms of ethnicity, religion, socioeconomic status and care needs.
CEO, center manager, four physicians, two licensed practical nurses, one medical secretary and one lab assistant.
A See-and-Treat unit was established to offer same-day service for acute unplanned visits. Standardized patient symptom forms were created that allowed patients to self-triage and then enter into a streamlined care process consisting of a quick diagnostic lab and a physician visit.
Volume, productivity, staff perceptions and patient satisfaction were measured through data on number and type of contacts per 1000 listed patients, visits per physician, observations, interviews and a questionnaire.
A significant decrease in the acute and total number of visits, a continued trend of diminishing telephone contacts, and a non-significant increase in physician productivity. Patients were very satisfied, and staff perceived an improved quality of care.
See-and-Treat appears to be a viable approach for a specific primary care patient segment interested in acute same-day-service. Opening up access and standardizing care made it possible to efficiently address these needs and engage patients.
探讨“看诊治疗”理念如何应用于初级保健领域及其对就诊量和工作效率的影响。
采用解释性单案例研究设计，结合混合方法，并按照 SQUIRE 2.0 指南呈现。
一家位于斯德哥尔摩郡的公共资助的私人初级保健服务提供商，为不同种族、宗教、社会经济地位和护理需求的患者提供服务。
首席执行官、中心经理、四位医生、两位持照护师、一位医疗秘书和一位实验室助理。
设立“看诊治疗”单元，为急性非计划性就诊提供当日服务。创建了标准化的患者症状表单，允许患者自我分诊，然后进入简化的护理流程，包括快速诊断实验室检查和医生就诊。
通过每 1000 名在册患者的接触次数和类型、每位医生的就诊次数、观察结果、访谈和问卷调查来衡量就诊量、工作效率、员工认知和患者满意度。
急性就诊和总就诊次数显著减少，电话咨询持续减少，医生工作效率略有提高。患者非常满意，员工认为护理质量得到改善。
“看诊治疗”理念似乎适用于对急性当日服务感兴趣的特定初级保健患者群体。开放就诊渠道和标准化护理使我们能够高效满足这些需求并与患者建立联系。
