Allan Jack A, Repanshek Zachary, Healy Megan E, DeAngelis Michael, Satz Wayne A, Ufberg Jacob W, Schreyer Kraftin E
Department of Emergency Medicine Temple University Hospital Philadelphia Pennsylvania USA.
AEM Educ Train. 2024 Dec 1;8(6):e11042. doi: 10.1002/aet2.11042. eCollection 2024 Dec.
Residents are required to participate in practice-based learning and improvement. Most commonly, a resident-initiated patient follow-up log is used to meet the requirement. We sought to provide residents with follow-up information in an efficient, value-added manner via a patient follow-up report (PFUR).
The PFUR is an automated monthly report sent to individual residents via email. It was generated from the electronic medical record and included five categories of cases: patients who were discharged and returned for admission within 72 h, diagnosis-based criteria, patients who expired during the hospital stay, patients who were admitted to or upgraded to the intensive care unit (ICU) within 24 h of admission, and patients independently flagged by the care team for follow-up. The PFURs were analyzed for 6 months after implementation for number and categorization of cases included as well as via survey of the residents.
In 6 months, 1078 patients, generating 1155 follow-ups, were included on the PFUR. ICU upgrades were the most represented category (41%), followed by diagnosis-based criteria (30%). Patients who were discharged and admitted within 72 h were least commonly represented on the PFUR (2%). Seventy-eight percent of residents felt that patient follow-ups were valuable to their education and 82% felt that the PFUR impacted the clinical care they provided. The PFUR was preferred by 90% of resident respondents and had an average value rating of 4.38 out of 5.
Overall numbers of patient follow-ups significantly increased after implementation of the PFUR. Certain categories were more represented overall and within each class, which has implications for future educational initiatives. After a pilot period, the novel PFUR appears to be more efficient, accessible, and highly valued than the log used previously. Programs looking to maximize the educational benefits of patient follow-ups may consider a similar initiative.
住院医师需要参与基于实践的学习与改进。最常见的是，使用住院医师发起的患者随访日志来满足这一要求。我们试图通过患者随访报告（PFUR）以高效、增值的方式为住院医师提供随访信息。
PFUR是一份每月自动生成并通过电子邮件发送给每位住院医师的报告。它由电子病历生成，包括五类病例：出院后72小时内再次入院的患者、基于诊断标准的病例、住院期间死亡的患者、入院后24小时内入住或升级到重症监护病房（ICU）的患者，以及护理团队独立标记需随访的患者。在实施后的6个月内，对PFUR中的病例数量和分类进行了分析，并对住院医师进行了调查。
在6个月内，PFUR纳入了1078例患者，产生了1155次随访。ICU升级是占比最高的类别（41%），其次是基于诊断标准的病例（30%）。出院后72小时内再次入院的患者在PFUR中的占比最少（2%）。78%的住院医师认为患者随访对他们的教育有价值，82%的住院医师认为PFUR影响了他们提供的临床护理。90%的住院医师受访者更喜欢PFUR，其平均价值评分在5分制中为4.38分。
实施PFUR后，患者随访的总体数量显著增加。某些类别在总体和每个类别中占比更高，这对未来的教育举措有影响。经过试点期后，新型PFUR似乎比之前使用的日志更高效、更易获取且更受重视。希望最大化患者随访教育效益的项目可考虑类似举措。
