初级保健患者和工作人员对自我入住（Self-Rooming）替代候诊室的看法。
Primary Care Patients' and Staff's Perceptions of Self-Rooming as Alternative to Waiting Rooms.
机构信息
Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Primary Care Academics Transforming Healthcare Collaborative, UW Health, Madison, Wisconsin.
出版信息
Ann Fam Med. 2023 Jan-Feb;21(1):46-53. doi: 10.1370/afm.2909.
PURPOSE
Most patients are escorted to exam rooms (escorted rooming) although patients directing themselves to their exam room (self-rooming) saves patient and staff time while increasing patient satisfaction. This study assesses patient and staff perceptions after pragmatic implementation of self-rooming.
METHODS
In October-December 2020, we surveyed patients and staff in 25 primary care clinics after our institution expanded self-rooming from 4 specially built clinics during the COVID-19 pandemic. Semi-structured surveys asked about rooming process used, rooming process preferred, and perceptions of self-rooming compared with escorted rooming.
RESULTS
Most patients (n = 1,561) preferred self-rooming (86%), especially among patients aged <65 years and in family medicine clinics. Few patients felt less welcomed (10.6%), less cared about (6.8%), more isolated (15.6%), more lost/confused (7.6%), or more frustrated (3.2%) with self-rooming compared with escorted rooming. Early-adopter clinics that implemented self-rooming ≤2016 had even lower rates of patients feeling more isolated, lost/confused, or frustrated with self-rooming compared with escorted rooming.Over one-half of staff (n = 241; 180 clinical, 61 nonclinical) preferred self-rooming (59%) and thought most patients liked self-rooming (65.8%), especially among clinical staff and in early adopter clinics (≤2016). Few staff reported worse waiting times for patients (12.4%), medical assistants (MAs) (15.9%), and clinicians (16.4%) or worse crowding in waiting areas (1.7%) and hallways (10.1%). Unlike patient-reported confusion (7.6%), most staff thought self-rooming led to more patient confusion (63.8%), except in early-adopter clinics (44.4%).
CONCLUSIONS
Self-rooming is a patient-centered innovation that is also acceptable to staff. We demonstrated that pragmatic implementation is feasible across primary care without expensive technology or specially designed buildings.
目的
大多数患者都是由医护人员护送进入诊室（护送式入室），而让患者自行前往诊室（自助式入室）可以节省患者和医护人员的时间，同时提高患者的满意度。本研究评估了在 COVID-19 大流行期间，我们将自助式入室从 4 个专门建造的诊室扩大到 25 个初级保健诊所后，患者和医护人员的看法。半结构化调查询问了使用的入室流程、首选的入室流程，以及与护送式入室相比，对自助式入室的看法。
方法
在 2020 年 10 月至 12 月期间，我们在机构将自助式入室从 COVID-19 大流行期间的 4 个专门建造的诊室扩大到 25 个初级保健诊所后，对 25 个初级保健诊所的患者和医护人员进行了调查。半结构化调查询问了使用的入室流程、首选的入室流程，以及与护送式入室相比，对自助式入室的看法。
结果
大多数患者（n=1561）更喜欢自助式入室（86%），尤其是年龄<65 岁和在家庭医学诊所的患者。少数患者（10.6%）感觉不如护送式入室那样受欢迎，（6.8%）感觉不如护送式入室那样关心，（15.6%）感觉不如护送式入室那样孤立，（7.6%）感觉不如护送式入室那样迷失/困惑，（3.2%）感觉不如护送式入室那样沮丧。而那些在 2016 年之前实施自助式入室的早期采用者诊所，患者感到更加孤立、迷失/困惑或沮丧的比例甚至更低。超过一半的医护人员（n=241；180 名临床医护人员，61 名非临床医护人员）更喜欢自助式入室（59%），并认为大多数患者喜欢自助式入室（65.8%），尤其是临床医护人员和早期采用者诊所（≤2016 年）。少数医护人员报告说患者的等待时间更差（12.4%），医疗助理（MA）（15.9%）和临床医生（16.4%），或等待区（1.7%）和走廊（10.1%）的拥挤情况更差。与患者报告的困惑（7.6%）不同，大多数医护人员认为自助式入室导致更多的患者困惑（63.8%），但在早期采用者诊所（44.4%）则并非如此。
结论
自助式入室是一种以患者为中心的创新，也能得到医护人员的认可。我们证明，在没有昂贵技术或专门设计的建筑的情况下，在整个初级保健领域实施这种方法是可行的。
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