Vitale Rebecca, Smith Samantha, Doolittle Benjamin R
Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Department of Orthopedics, Yale University School of Medicine, New Haven, Connecticut, USA.
Fam Med Community Health. 2019 Dec 2;7(4):e000208. doi: 10.1136/fmch-2019-000208. eCollection 2019.
The objective of this study was to improve the telephone communication experience for patients in a primary care practice.
An exploratory survey was conducted that revealed suboptimal patient satisfaction with clinic access due to the telephone triage system. Several interventions were designed: a monthly quality meeting was established among clinic staff, all phone interactions were recorded in the electronic medical record (EMR) and clinic appointments were made available several months in advance. A follow-up survey was conducted to evaluate these interventions.
The study was conducted in a multispecialty, urban-based, resident-faculty practice from November 2016 to November 2017.
Subjects were recruited in a convenience sample from the waiting room. 200 subjects participated in the initial survey and 215 in the second survey.
After the interventions, patients felt that their questions were answered more frequently than before (p<0.01). They also felt that appointments were easier to make (p=0.03). A similar number of patients reported seeking emergency care because they were unable to reach a provider (33.8% vs 31.9%, p=0.68). The percentage of patients who received a call back within 24 hours increased, but it was not statistically significant (38.6% vs 44%, p=0.13).
Improving telephone triage through implementing a monthly quality improvement meeting, optimising use of the EMR and opening schedules several months in advance resulted in several improvements in the patient experience, but did not change use of emergency services. Further interventions, including increased resource allocation, are needed to optimise patient experience.
本研究的目的是改善基层医疗实践中患者的电话沟通体验。
进行了一项探索性调查,结果显示由于电话分诊系统,患者对诊所就诊的满意度欠佳。设计了多项干预措施:在诊所工作人员之间每月召开一次质量会议,所有电话互动都记录在电子病历(EMR)中,并且提前数月提供诊所预约服务。进行了一项后续调查以评估这些干预措施。
该研究于2016年11月至2017年11月在一家位于城市的多专科住院医师 - 教员诊所进行。
从候诊室中以便利抽样方式招募受试者。200名受试者参与了初始调查,215名参与了第二次调查。
干预措施实施后,患者感觉他们的问题比以前得到了更频繁的解答(p<0.01)。他们还感觉预约更容易了(p = 0.03)。报告因无法联系到医护人员而寻求紧急护理的患者数量相似(33.8%对31.9%,p = 0.68)。在24小时内接到回电的患者百分比有所增加,但无统计学意义(38.6%对44%,p = 0.13)。
通过每月召开质量改进会议、优化电子病历的使用以及提前数月开放时间表来改善电话分诊系统,使患者体验有了多项改善,但并未改变紧急服务的使用情况。需要进一步的干预措施(包括增加资源分配)来优化患者体验。