Jt Comm J Qual Patient Saf. 2023 Dec;49(12):712-715. doi: 10.1016/j.jcjq.2023.07.005. Epub 2023 Jul 22.
Outpatient clinic letters are recognized as an important component of patient care. This project aimed to coproduce clinic letters that have meaning and relevance for key stakeholders.
This health care improvement project was conducted in one musculoskeletal therapy (physiotherapy and osteopathy) department in southern England using a Lean Six Sigma Define, Measure, Analyze, Improve, and Control-inspired framework. The views and experiences of key stakeholders, including therapists, general practitioners, and patients, were explored using surveys and group meeting methods. New letter designs were coproduced with stakeholders, including patient partners and personalized care lead staff, and were refined through a pilot phase. Qualitative data were analyzed thematically, and quantitative data were analyzed descriptively.
Overall, patients and therapists found the clinic letters an important and meaningful part of care. However, therapists reported that they often did not write the letters, and time was identified as the main barrier. The main theme identified from patient feedback was that patients wanted to write the letters in collaboration with the clinician. The pilot phase demonstrated that, on average, the new letters took less time to write.
This project has coproduced new clinic letters and operational processes centered on the needs of key stakeholders. This article will help other outpatient departments reflect on their own clinic letters and consider their meaning and relevance for their stakeholders.
门诊病历是患者治疗的重要组成部分。本项目旨在为主要利益相关者生成有意义和相关的临床病历。
本医疗保健改进项目在英格兰南部的一个肌肉骨骼治疗(物理治疗和整骨疗法)部门进行,使用了精益六西格玛“定义、测量、分析、改进和控制”(Define, Measure, Analyze, Improve, and Control)框架。采用问卷调查和小组会议的方法,探索了主要利益相关者(包括治疗师、全科医生和患者)的意见和经验。与利益相关者(包括患者伙伴和个性化护理主管人员)共同设计了新的病历,并在试点阶段进行了改进。对定性数据进行了主题分析,对定量数据进行了描述性分析。
总体而言,患者和治疗师都认为病历是治疗过程中重要且有意义的一部分。然而,治疗师报告说他们经常不写病历,时间是主要障碍。从患者反馈中得出的主要主题是患者希望与临床医生共同书写病历。试点阶段表明,新病历的平均书写时间更短。
本项目围绕主要利益相关者的需求生成了新的临床病历和操作流程。本文将帮助其他门诊部门思考自身的临床病历,考虑其对利益相关者的意义和相关性。