Graf Anneke, Koh Chan Hee, Caldwell Gordon, Grieve Joan, Tan Melissa, Hassan Jasmine, Bakaya Kaushiki, Marcus Hani J, Baldeweg Stephanie E
Department of Endocrinology, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UK.
Department of Neurosurgery, University College London Hospitals NHS Foundation Trust, London WC1N 3BG, UK.
Clin Pract. 2022 Jul 14;12(4):545-556. doi: 10.3390/clinpract12040058.
The coronavirus disease 2019 pandemic may have affected the quality of clinical consultations. The objective was to use 10 proposed quality indicator questions to assess outpatient consultation quality; to assess whether the recent shift to telemedicine during the pandemic has affected consultation quality; and to determine whether consultation quality is associated with satisfaction and consultation outcome. A cross-sectional study was used to survey clinicians and patients after outpatient consultations (1 February to 31 March 2021). The consultation quality score (CQS) was the sum of ‘yes’ responses to the survey questions. In total, 78% (538/690) of consultations conducted were assessed by a patient, clinician, or both. Patient survey response rate was 60% (415/690) and clinician 42% (291/690). Face-to-face consultations had a greater CQS than telephone (patients and clinicians < 0.001). A greater CQS was associated with higher overall satisfaction (clinicians log-odds: 0.77 ± 0.52, p = 0.004; patients log-odds: 1.35 ± 0.57, p < 0.001) and with definitive consultation outcomes (clinician log-odds: 0.44 ± 0.36, p = 0.03). In conclusion, consultation quality is assessable; the shift to telemedicine has negatively impacted consultation quality; and high-quality consultations are associated with greater satisfaction and definitive consultation outcome decisions.
2019年冠状病毒病大流行可能影响了临床会诊的质量。目的是使用10个提议的质量指标问题来评估门诊会诊质量；评估大流行期间最近向远程医疗的转变是否影响了会诊质量；并确定会诊质量是否与满意度和会诊结果相关。采用横断面研究在门诊会诊后（2021年2月1日至3月31日）对临床医生和患者进行调查。会诊质量得分（CQS）是对调查问题回答“是”的总和。总共，78%（538/690）的会诊由患者、临床医生或两者进行评估。患者调查回复率为60%（415/690），临床医生为42%（291/690）。面对面会诊的CQS高于电话会诊（患者和临床医生<0.001）。更高的CQS与更高的总体满意度相关（临床医生对数优势比：0.77±0.52，p = 0.004；患者对数优势比：1.35±0.57，p<0.001），也与明确的会诊结果相关（临床医生对数优势比：0.44±0.36，p = 0.03）。总之，会诊质量是可评估的；向远程医疗的转变对会诊质量产生了负面影响；高质量的会诊与更高的满意度和明确的会诊结果决策相关。
