Department of Health Sciences Research.
Center for the Science of Health Care Delivery.
Med Care. 2019 May;57 Suppl 5 Suppl 1:S73-S79. doi: 10.1097/MLR.0000000000001095.
What if you could only ask one question of the patient during a clinic visit? Further, suppose the patient's biggest concern can pragmatically be incorporated into routine clinical care and clinical pathways that can address the patient's single biggest concern can be identified. If the principal concern can be dealt with efficiently at each visit through key stakeholder case management, positive outcomes should result. Therefore, motivated by the need for patient-centered health care visits, the Beacon electronic patient-reported outcomes (PRO) quality of life (QOL) tool was developed.
Central to the tool is that at each health care visit, the patient's biggest concern is electronically communicated to the health care team. Therefore, the tool can help catalyze important discussions between the health care team and the patient, perhaps on topics that would not have been discussed otherwise at a routine visit. In recognition of the community of resources needed to provide comprehensive care, the tool generates clinical pathways or actions that can be pursued to address the patient's biggest concern. The concern is efficiently triaged such that members of the health care community with appropriate expertise and resources are identified to address and manage that single biggest concern signaled by the patient. A report, which can be uploaded into the patient's medical chart, is created and provides a list of resources for a case manager to assist the patient and contains graphical presentations of the patient's QOL and a history of prior concerns. The report also labels potentially significant changes in QOL.
The tool, which has been applied successfully in several health conditions, acts as a beacon to health care providers so that a patient's self-reported concern can be consistently and effectively integrated into their care.
It is impractical to try to deal with every patient concern in every visit. The key to the Beacon tool is that at each visit the patient's biggest concern is identified, clinical pathways indicated, and resources efficiently matched to address the patient's biggest concern.
如果您在就诊期间只能向患者问一个问题，那会怎样？进一步假设，患者最大的关注点可以切实纳入常规临床护理中，并可以确定可解决患者最大关注点的临床路径。如果通过主要利益相关者的病例管理，能够在每次就诊时有效地处理主要关注点，那么应该会产生积极的结果。因此，出于对以患者为中心的医疗就诊的需求，开发了 Beacon 电子患者报告结果（PRO）生活质量（QOL）工具。
该工具的核心是，在每次就诊时，患者最大的关注点都会通过电子方式传达给医疗团队。因此，该工具可以帮助促进医疗团队与患者之间的重要讨论，也许是在常规就诊中不会讨论的话题。鉴于提供全面护理所需的社区资源，该工具会生成可以用来解决患者最大关注点的临床路径或行动。关注点被有效地进行分诊，以便识别具有适当专业知识和资源的医疗团队成员来解决和管理患者所提出的单一最大关注点。创建了一份报告，可以上传到患者的病历中，该报告提供了病例管理员帮助患者的资源列表，并包含患者 QOL 的图形表示以及之前关注点的历史记录。该报告还标记了 QOL 中潜在的显著变化。
该工具已成功应用于多种健康状况，它就像医疗保健提供者的灯塔，使患者自我报告的关注点能够始终如一地并有效地纳入他们的护理中。
在每次就诊中尝试解决每个患者的关注点是不切实际的。Beacon 工具的关键是，在每次就诊时确定患者最大的关注点，指示临床路径，并有效地匹配资源来解决患者最大的关注点。
