Loftus Conor G, Ebbert Jon O, Aakre Christopher A, Caine Natalie A, DeZutter Meredith A, Eastman Ryan J, Fischer Stephen M, Gilman Elizabeth A, Johnson Matthew G, Luedtke Connie A, Mohabbat Arya B, Reinschmidt Karen J, Roellinger Daniel L, Sanchez William, Philpot Lindsey M
Division of Gastroenterology and Hepatology.
Department of Community Internal Medicine.
Mayo Clin Proc Innov Qual Outcomes. 2021 Dec 23;6(1):45-54. doi: 10.1016/j.mayocpiqo.2021.11.003. eCollection 2022 Feb.
To design and evaluate, through a human-centered design approach, a multispeciality clinic for patients with central sensitization syndromes that combined virtual previsit consultations, traditional face-to-face appointments, and technology-enabled educational programming.
Patients with suspected fibromyalgia and chronic abdominal pain were seen in a multispecialty practice, and the performance of the clinic was evaluated against a contemporary cohort. Quantitative and qualitative evaluation measures included team estimates of time spent on care-related tasks, physician rank of alignment of patient need with clinic design, major appointment changes, and nonvisit care tasks. Members of the care team also evaluated strengths, weaknesses, opportunities, and threats to the success of the clinic.
The pilot clinic was operated from April 1, 2020, to April 30, 2021, and included 34 patients with suspected fibromyalgia/chronic abdominal pain. During the pilot period, physicians ranked the value of the virtual previsit consultations in providing care as 7.5 on a scale of 0 to 10 and reported an average of 50 minutes in preparation for the appointment, execution of the appointment, and postvisit documentation. We did not observe substantial differences in the number of added appointments or messages received within the patient portal when compared with a comparison cohort. Patients who participated in the combination nurse educator-led and digital education program provided positive feedback about their experience.
Our clinic model provides a framework for the treatment of patients with debilitating centrally sensitized conditions and future expansion of virtual care delivery models to better meet patient care and educational needs.
通过以人为本的设计方法，设计并评估一个针对中枢敏化综合征患者的多专科诊所，该诊所结合了虚拟就诊前咨询、传统面对面预约以及技术支持的教育项目。
在一个多专科医疗机构中诊治疑似纤维肌痛和慢性腹痛的患者，并与当代队列进行比较来评估该诊所的表现。定量和定性评估指标包括团队对护理相关任务所花费时间的估计、医生对患者需求与诊所设计匹配度的排名、主要预约变更以及非就诊护理任务。护理团队成员还评估了诊所成功的优势、劣势、机会和威胁。
试点诊所于2020年4月1日至2021年4月30日运营，纳入了34例疑似纤维肌痛/慢性腹痛患者。在试点期间，医生对虚拟就诊前咨询在提供护理方面的价值评分为7.5（满分10分），并报告平均花费50分钟进行预约准备、预约执行和就诊后记录。与对照组相比，我们未观察到患者门户内新增预约或收到消息数量的显著差异。参与护士教育者主导和数字教育相结合项目的患者对他们的体验给予了积极反馈。
我们的诊所模式为治疗患有使人衰弱的中枢敏化疾病的患者提供了一个框架，并为未来扩展虚拟护理服务模式以更好地满足患者护理和教育需求提供了框架。
