患者就医管理框架:来自美国医疗系统领导者德尔菲小组的共识

A framework for patient access management: consensus from a Delphi panel of US health system leaders.

作者信息

Woodcock Elizabeth, Profeta Chris

机构信息

Patient Access Collaborative, Emory University Rollins School of Public Health, .

Patient Access Collaborative, Emory University Rollins School of Public Health.

出版信息

BMC Health Serv Res. 2025 Apr 9;25(1):524. doi: 10.1186/s12913-025-12561-8.

Abstract

BACKGROUND

Patient access management in the ambulatory setting is important for health systems as waits and delays lead to reduced health outcomes, inequity, and poor patient experience. Health systems may benefit from a framework that catalogs the determinants of access management in the ambulatory setting to deliver timely care to all patients.

METHODS

The aim of this research is to define patient access and document the determinants of patient access management through a consensus from a two-stage Delphi panel of access leaders in US academic health systems and children's hospitals.

RESULTS

The study demonstrates a patient-centered definition of patient access management focusing on the delivery of timely, simple, connected access to care. Twelve major determinants were identified for patient access management: executive leadership support, dedicated access leadership, system strategy prioritization, data collection and analysis, contact center management, capacity management, appointment availability, appointment accuracy, measurable and defined goals, simplification of system for patients, timely offering of care, and patient-clinician connection. The determinants were applied to a framework using the Donabedian model. Frameworks may improve validity and reliability in performance improvement activities.

CONCLUSIONS

Health systems may benefit from prescriptive strategies to identify, diagnose, resource, and address the determinants that constitute patient access management. Additional research is warranted to understand each determinant.

摘要

背景

门诊环境中的患者就医管理对卫生系统很重要,因为等待和延误导致健康结果下降、不公平以及患者体验不佳。卫生系统可能会从一个框架中受益,该框架对门诊环境中就医管理的决定因素进行分类,以便为所有患者提供及时的护理。

方法

本研究的目的是通过美国学术卫生系统和儿童医院的两阶段德尔菲专家小组的共识,定义患者就医并记录患者就医管理的决定因素。

结果

该研究展示了以患者为中心的患者就医管理定义,重点是提供及时、简单、连贯的就医服务。确定了患者就医管理的十二个主要决定因素:行政领导支持、专门的就医领导、系统战略优先级、数据收集与分析、联络中心管理、能力管理、预约可用性、预约准确性、可衡量和明确的目标、简化患者系统、及时提供护理以及患者与临床医生的联系。这些决定因素被应用于一个使用唐纳贝迪安模型的框架。框架可能会提高绩效改进活动的有效性和可靠性。

结论

卫生系统可能会从规范性策略中受益,以识别、诊断、提供资源并解决构成患者就医管理的决定因素。有必要进行更多研究以了解每个决定因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d03/11983827/d1ac5fc90614/12913_2025_12561_Fig1_HTML.jpg

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