Santoro Stephanie L, Brenner-Miller Diana, Cottrell Clorinda, Bress Joy, Torres Amy, Skotko Brian G
Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Mass.
Department of Pediatrics, Harvard Medical School, Boston, Mass.
Pediatr Qual Saf. 2021 Sep 24;6(5):e472. doi: 10.1097/pq9.0000000000000472. eCollection 2021 Sep-Oct.
Multiple clinic models for Down syndrome exist; one model is the multidisciplinary, specialty clinic, such as the Massachusetts General Hospital Down Syndrome Program (MGH DSP).
Intrateam communication was identified as an area for improvement. Our team developed an intervention, the Passport, a paper-based communication tool passed by parents between clinical teams who evaluated the same patients in different locations. Metrics included an electronic survey of parents and clinicians and tracking the frequency of Passport use. The analysis included the use of Statistical Process Control charts and rules.
The parental suggestions for communication-based interactions improved from 54% (32/60) to 17% (3/18) ( 0.01). Communication scores within the MGH DSP team and between the team and parents were high at 86% and 96%, respectively. Overall satisfaction with the MGH DSP remained consistently high during our project, with a mean score of 6.49 out of 7. The MGH DSP team members reported communication scores with a mean of 85 out of 100.
Implementation of a paper Passport tool incorporated parents in the real-time, intraclinic communication between our MGH DSP teams, leading to improved communication suggestions and high marks on the other metrics followed. Such a tool could be useful for other multidisciplinary clinics where team members evaluate the same patients at different locations on the same day.
存在多种唐氏综合征临床诊疗模式；其中一种模式是多学科专科诊所，如麻省总医院唐氏综合征诊疗项目（MGH DSP）。
团队内部沟通被确定为一个有待改进的领域。我们的团队开发了一种干预措施，即“护照”，这是一种纸质沟通工具，由家长在不同地点对同一患者进行评估的临床团队之间传递。指标包括对家长和临床医生的电子调查以及跟踪“护照”的使用频率。分析包括使用统计过程控制图和规则。
基于沟通的互动方面，家长提出的建议从54%（32/60）降至17%（3/18）（P<0.01）。MGH DSP团队内部以及团队与家长之间的沟通得分分别很高，为86%和96%。在我们的项目期间，对MGH DSP的总体满意度一直很高，平均得分为6.49（满分7分）。MGH DSP团队成员报告的沟通得分平均为85分（满分100分）。
实施纸质“护照”工具让家长参与到MGH DSP团队之间的实时诊所内沟通中，从而改进了沟通建议，并在其他后续指标上获得高分。这样的工具可能对其他多学科诊所有用，在这些诊所中，团队成员在同一天在不同地点对同一患者进行评估。
