Pritzker School of Medicine, University of Chicago, 924 E 57th St, Ste #104, Chicago, IL 60637, USA.
Pritzker School of Medicine, University of Chicago, 924 E 57th St, Ste #104, Chicago, IL 60637, USA; Department of Family Medicine, University of Chicago, 5841 S Maryland Ave., MC 7110, Chicago, IL 60637, USA; NorthShore University HealthSystem (NSUHS) Research Institute, 1001 University Pl, Evanston, IL, 60201, USA.
Contraception. 2021 Jan;103(1):6-12. doi: 10.1016/j.contraception.2020.10.018. Epub 2020 Oct 29.
We evaluated the effect of clinic level implementation of the One Key Question (OKQ) intervention, including physician and staff training and workflow adjustments, on reproductive counseling and patient satisfaction in primary care and ob/gyn.
We implemented the OKQ intervention in one primary care and one ob/gyn practice, while observing another primary care and ob/gyn practice that each provided usual care (control practices). We surveyed separate patient cohorts at two time points: 26 before and 33 after the primary care practice implemented OKQ, 38 before and 36 after the ob/gyn practice implemented OKQ, 26 and 37 at the primary care control practice, and 31 and 37 at the ob/gyn control practice. We used chi square tests to assess OKQ's effects on counseling rates and patient satisfaction, comparing intervention to control practices across time points.
In primary care, from before to after implementation, the intervention practice did not significantly increase reproductive counseling (69-76%, p = 0.58), but increased patient satisfaction (81-97%, p = 0.04) while the control practice demonstrated a decrease in patient satisfaction over the same time periods. In the ob/gyn clinics, no significant change in reproductive counseling or patient satisfaction was seen in the intervention practice, while the control practice demonstrated a decrease in patient satisfaction.
Implementing OKQ appears to increase patient satisfaction. Larger studies are needed to assess whether this clinic-level intervention may increase reproductive counseling.
Further studies of the impact of clinic-level implementation of OKQ are needed.
我们评估了在初级保健和妇产科实践中实施 One Key Question（OKQ）干预措施，包括医生和员工培训以及工作流程调整，对生殖咨询和患者满意度的影响。
我们在一个初级保健和一个妇产科诊所实施了 OKQ 干预措施，同时观察另一个初级保健和妇产科诊所，每个诊所提供常规护理（对照诊所）。我们在两个时间点对单独的患者队列进行了调查：在初级保健诊所实施 OKQ 之前有 26 名患者，之后有 33 名患者；在妇产科诊所实施 OKQ 之前有 38 名患者，之后有 36 名患者；在初级保健对照诊所有 26 名和 37 名患者，在妇产科对照诊所有 31 名和 37 名患者。我们使用卡方检验来评估 OKQ 对咨询率和患者满意度的影响，比较干预组和对照组在不同时间点的效果。
在初级保健中，从实施前到实施后，干预组的生殖咨询并没有显著增加（69-76%，p=0.58），但患者满意度增加（81-97%，p=0.04），而对照组在同一时间段内患者满意度下降。在妇产科诊所，干预组的生殖咨询或患者满意度没有显著变化，而对照组的患者满意度下降。
实施 OKQ 似乎可以提高患者满意度。需要进行更大规模的研究来评估这种诊所层面的干预措施是否可以增加生殖咨询。
需要进一步研究 OKQ 在诊所层面实施的影响。
