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分诊住院患者:住院医师教育的机会。

Triaging Inpatient Admissions: an Opportunity for Resident Education.

机构信息

Department of Medicine, South Texas Veterans Health Care System, San Antonio, TX, USA.

Division of General and Hospital Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

出版信息

J Gen Intern Med. 2019 May;34(5):754-757. doi: 10.1007/s11606-019-04882-2.

Abstract

In the context of internal medicine, "triage" is a newly popularized term that refers to constellation of activities related to determining the most appropriate disposition plans for patients, including assessing patients for admissions into the inpatient medicine service. The physician or "triagist" plays a critical role in the transition of care from the outpatient to the inpatient settings, yet little literature exists addressing this particular transition. The importance of this set of responsibilities has evolved over time as health systems become increasingly complex to navigate for physicians and patients. With the emphasis on hospital efficiency metrics such as emergency department throughput and appropriateness of admissions, this type of systems-based thinking is a necessary skill for practicing contemporary inpatient medicine. We believe that triaging admissions is a critical transition in the care continuum and represents an entrustable professional activity that integrates skills across multiple Accreditation Council for Graduate Medical Education (ACGME) competencies that internal medicine residents must master. Specific curricular competencies that address the domains of provider, system, and patient will deliver a solid foundation to fill a gap in skills and knowledge for the triagist role in IM residency training.

摘要

在内科学领域,“分诊”是一个新流行的术语,指的是与确定患者最合适的处置计划相关的一系列活动,包括评估患者是否需要住院接受内科服务。医生或“分诊员”在从门诊到住院的护理过渡中起着至关重要的作用,但关于这一特定过渡的文献很少。随着医疗系统对医生和患者来说变得越来越复杂,这一系列职责的重要性也在不断发展。随着对医院效率指标(如急诊科吞吐量和入院适宜性)的重视,这种基于系统的思维方式是从事当代住院内科的必要技能。我们认为,住院患者的分诊是护理连续体中的一个关键过渡,代表了一种可委托的专业活动,它整合了多个内科住院医师必须掌握的住院医师毕业后医学教育认证委员会(ACGME)能力中的多个技能。针对提供者、系统和患者领域的具体课程能力将为填补内科住院医师培训中分诊员角色的技能和知识差距提供坚实的基础。

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