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由物理治疗师主导的肌肉骨骼电话分诊与咨询服务:急诊科转诊患者的有效选择

Physiotherapy-Led Musculoskeletal Telephone Triage and Advice Service: A Valid Option for Patients Referred From the Emergency Department.

作者信息

Dowell Richard J, Dattani Janki, Nagy Mohamed, Al Wadiya Ahmed, Maher Moustafa, Ashwood Neil

机构信息

Emergency Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, GBR.

Physiotherapy Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, GBR.

出版信息

Cureus. 2023 Feb 7;15(2):e34720. doi: 10.7759/cureus.34720. eCollection 2023 Feb.

Abstract

Introduction Musculoskeletal (MSK) conditions create a significant demand for healthcare services in the United Kingdom. The emergency department is one of the main providers of initial care for patients with MSK disorders or injuries. As attendances increase within the emergency department the demand for MSK physiotherapy services also increases. The MSK physiotherapy department at Queens Hospital, Burton, GBR introduced a telephone triage and advice (TTAD) service for patients referred from the emergency department to try and reduce waiting times and the number of initial appointments not attended. The primary outcome of the study was to investigate the number of patients discharged via the TTAD service. Secondly, the study aimed to assess if the TTAD service eased the pressures of face-to-face appointments as well as analyze the effects on the number of failed attendances and canceled appointments for both initial and follow-up face-to-face appointments. Method Data were collected retrospectively from the electronic medical records system Meditech Version 6 (Medical Information Technology, Inc., MA) from the months of August, September, and October in 2017 (pre-TTAD) and 2018 (post-TTAD). Once the data had been collected, analysis was performed comparing results from 2017 to 2018 using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) analysis software. Results The overall number of referrals from emergency to MSK physiotherapy increased by 11.2% between 2017 and 2018. Following the introduction of the TTAD service, 59.8% of the total referrals were offered a face-to-face initial appointment with 40.2% of patients referred being discharged via the TTAD service in 2018. The percentage of patients that failed to attend the initial appointment in 2018 also fell by 4.9%. Conclusion The introduction of a TTAD service for referrals from the emergency department has been demonstrated to be effective in reducing the number of face-to-face appointments required in the MSK physiotherapy management of these patients. Both initial and follow-up face-to-face appointments were lower in 2018 when compared to 2017, this is despite an 11.2% increase in the number of referrals throughout August, September, and October. It can therefore be concluded that the TTAD service also had a positive impact on the failed attendance rate of initial face-to-face appointments.

摘要

引言

肌肉骨骼(MSK)疾病在英国对医疗服务产生了巨大需求。急诊科是为患有MSK疾病或损伤的患者提供初始护理的主要机构之一。随着急诊科就诊人数的增加,对MSK物理治疗服务的需求也在增加。英国伯顿女王医院的MSK物理治疗科为从急诊科转诊的患者引入了电话分诊与建议(TTAD)服务,以试图减少等待时间以及未就诊的初次预约数量。该研究的主要结果是调查通过TTAD服务出院的患者数量。其次,该研究旨在评估TTAD服务是否缓解了面对面预约的压力,并分析其对初次和后续面对面预约中未就诊和取消预约数量的影响。

方法

数据从电子病历系统Meditech版本6(医疗信息技术公司,马萨诸塞州)中回顾性收集,数据来自2017年(TTAD服务实施前)和2018年(TTAD服务实施后)的8月、9月和10月。数据收集完成后,使用统计产品与服务解决方案(SPSS)(适用于Windows的IBM SPSS Statistics,纽约州阿蒙克)分析软件对2017年和2018年的结果进行比较分析。

结果

2017年至2018年期间,从急诊科转诊至MSK物理治疗科的患者总数增加了11.2%。引入TTAD服务后,2018年总转诊患者中有59.8%获得了面对面的初次预约,40.2%的转诊患者通过TTAD服务出院。2018年未参加初次预约的患者百分比也下降了4.9%。

结论

已证明为急诊科转诊患者引入TTAD服务可有效减少这些患者在MSK物理治疗管理中所需的面对面预约数量。与2017年相比,2018年的初次和后续面对面预约数量均有所减少,尽管8月、9月和10月期间转诊数量增加了11.2%。因此可以得出结论,TTAD服务对初次面对面预约的未就诊率也产生了积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8048/9998116/5644d73a905f/cureus-0015-00000034720-i01.jpg

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