Moxey Jordan, Murdoch Will
Sandwell and West Birmingham Hospital Trust.
Laurie Pike Health Centre.
Br J Gen Pract. 2020 Jun;70(suppl 1). doi: 10.3399/bjgp20X711065.
Rising demand makes it increasingly difficult for patients to access appointments. Laurie Pike Health Centre (LPHC) operates a predominantly same-day booking policy in order to manage appointment requests from its 18 000 patients. We sought to quantify the number of requests, in order to estimate the unmet demand.
We created a data collection tool to count the total number of patient requests by type. We grouped types into four categories: 1) medical appointment requests; 2) sick notes and results requests; 3) other appointment requests (such as healthcare assistant, nurse); and 4) admin/other. Category-specific percentages were applied to call log data to estimate the number of appointment requests per category. Capacity was measured by counting the total number of same-day GP/advanced nurse practitioner (ANP) appointment slots. Consultation records for GP/ANP appointments were analysed to assess the appropriateness of the booking.
Estimated average demand for same-day GP/ANP appointments was 222 per day. Average same-day capacity was 112 slots. After introducing pharmacist and video consultations, average capacity increased to 194 slots per day, a shortfall of 28 appointments. Consultation records indicated that 41% of GP/ANP appointments could have been seen by other practitioners; for example, musculoskeletal practitioners (14%).
GP/ANP appointments alone cannot meet patient demand but a diversified workforce might. Alongside this, efforts to improve care navigation may free up to 41% of GP/ANP appointment slots.
需求不断增加,患者越来越难预约到就诊时间。劳里·派克健康中心(LPHC)实行主要为当日预约的政策,以处理其18000名患者的预约请求。我们试图量化请求数量,以估计未满足的需求。
1)估计当日预约的已满足和未满足需求;2)评估当日预约的能力与需求相比情况如何;3)分析LPHC对可用预约时段的利用情况。
我们创建了一个数据收集工具,按类型统计患者请求的总数。我们将类型分为四类:1)医疗预约请求;2)病假条和检查结果请求;3)其他预约请求(如医疗保健助理、护士);4)行政/其他。将特定类别的百分比应用于通话记录数据,以估计每个类别的预约请求数量。通过计算当日全科医生/高级执业护士(ANP)预约时段的总数来衡量能力。分析全科医生/ANP预约的咨询记录,以评估预约的合理性。
估计当日全科医生/ANP预约的平均需求为每天222次。当日平均预约能力为112个时段。引入药剂师和视频咨询后,平均能力增加到每天194个时段,仍短缺28个预约。咨询记录显示,41%的全科医生/ANP预约可由其他从业者处理,例如肌肉骨骼疾病从业者(14%)。
仅靠全科医生/ANP预约无法满足患者需求,但多元化的医疗团队可能可以。除此之外,改善就诊引导的努力可能会释放多达41%的全科医生/ANP预约时段。