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远程查房具有临床价值,并使忙碌的外科医生成为可能:一位结直肠外科医生的十年经验。

Telerounding Has Clinical Value and Enables the Busy Surgeon: A Colorectal Surgeon's Ten-Year Experience.

机构信息

Department of Surgery, 6595University of Pittsburgh, Pittsburgh, PA, USA.

出版信息

Am Surg. 2022 Dec;88(12):2923-2927. doi: 10.1177/00031348211011131. Epub 2021 Apr 18.

DOI:10.1177/00031348211011131
PMID:33866864
Abstract

BACKGROUND

Study of telemedicine and telerounding in surgical specialties is limited. The push for telemedicine during the COVID-19 pandemic has challenged the face-to-face rounding paradigm and creates an opportunity for reflection on the benefits of telemedicine, especially for balancing competing corporate and clinical demands.

METHODS

The 117-month video-based inpatient telerounding experience of a colorectal surgeon in an academic medical system was recorded, including patient characteristics, diagnoses, technology, content of telerounding encounters, and logistical considerations. Data were analyzed using descriptive statistics.

RESULTS

163 patients were seen in 201 telerounding encounters, primarily for routine postoperative care (90.5%). Most were admitted for inflammatory bowel disease (63.2%). Changes were made to plans of care during 28.9% of encounters, and discharge planning was part of 26.4%. Encounters were conducted primarily from the surgeon's administrative office (68.7%) or other work-related locations (10.9%), while 6.5% originated from the surgeon's home. Technologic issues occurred in 5.5% of encounters. 89.1% of patient feedback was positive and none was negative.

CONCLUSION

Telerounding is technologically feasible and has clinical value, including for patients with complex surgical problems. Technologic problems are rare and patient satisfaction is high. Surgeons should consider telerounding as a means to balance competing demands.

摘要

背景

外科专业的远程医疗和远程查房研究有限。在 COVID-19 大流行期间推动远程医疗,挑战了面对面查房模式,并为反思远程医疗的益处创造了机会,尤其是在平衡竞争的企业和临床需求方面。

方法

记录了一位在学术医疗系统工作的结直肠外科医生基于视频的 117 个月的住院患者远程查房经验,包括患者特征、诊断、技术、远程查房的内容以及后勤方面的考虑。使用描述性统计数据对数据进行分析。

结果

201 次远程查房共涉及 163 名患者,主要是为了常规的术后护理(90.5%)。大多数是因炎症性肠病(63.2%)入院。在 28.9%的查房中更改了护理计划,26.4%的查房涉及出院计划。查房主要在外科医生的行政办公室(68.7%)或其他与工作相关的地点(10.9%)进行,而 6.5%则是从外科医生的家中发起。在 5.5%的查房中出现了技术问题。89.1%的患者反馈是积极的,没有负面的。

结论

远程查房在技术上是可行的,具有临床价值,包括对有复杂手术问题的患者。技术问题很少见,患者满意度很高。外科医生应考虑将远程查房作为平衡竞争需求的一种手段。

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Am Surg. 2022 Dec;88(12):2923-2927. doi: 10.1177/00031348211011131. Epub 2021 Apr 18.
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