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缩小差距:通过每月电话沟通加强初级保健医生与精神科医生之间的协作

Bridging the gap: monthly telephone calls to enhance collaboration between primary care physicians and psychiatrists.

作者信息

Vasudev Kamini, Fernando Stephanie

机构信息

Outpatient Psychiatry, London Health Sciences Centre, London, Ontario, Canada

Department of Psychiatry, Western University, London, Ontario, Canada.

出版信息

BMJ Open Qual. 2025 Aug 4;14(3):e003328. doi: 10.1136/bmjoq-2025-003328.

Abstract

BACKGROUND

The integration of mental health services within primary care settings is a growing priority in Canada, driven by the need to improve access and ensure comprehensive patient-centred care. This year-long pilot quality improvement (QI) project was conducted to examine the feasibility and impact of introducing monthly telephone consultations between primary care physicians (PCPs) and psychiatrists working at a secondary care regional hospital in Ontario, Canada.

METHODS

PCPs were connected with a team of psychiatrists via email on a voluntary basis. Once connected, PCPs were encouraged to contact psychiatrists by text or email to book monthly telephone consultation for patient care.

RESULTS

A total of seven PCPs and five psychiatrists participated in this project. A total of 66 patients were discussed via telephone consultations between PCPs and psychiatrists and 11 of these patients were referred to psychiatry for further assessment. The number of referrals to psychiatry O-P service from the seven PCPs involved in this pilot decreased from 83 for the period of November 2021 to October 2022 to 53 for the period of this project, that is, November 2022 to October 2023.There were initial challenges in scheduling consultations due to busy practices. After the first few months of regular monthly contact, three psychiatrists reported fewer ongoing contacts with PCPs and that PCPs email them on an as needed basis. Two psychiatrists continued to have ongoing 4-6 weeks contact with their assigned PCP, discussing on average 3-4 patients, after 1 year.Psychiatrists found the telephone meetings productive and the PCPs were appreciative of the support provided and were willing to take over the primary care of some patients under the care of the psychiatrists, who had medical needs but no PCP.

CONCLUSION

This pilot QI project confirms the feasibility and successful collaborations between PCPs and psychiatrists through monthly phone calls.

摘要

背景

在加拿大,由于需要改善服务可及性并确保以患者为中心的全面护理,将心理健康服务纳入初级保健机构已成为日益重要的优先事项。开展了这项为期一年的试点质量改进(QI)项目,以检验在加拿大安大略省一家二级护理区域医院工作的初级保健医生(PCP)与精神科医生之间引入每月电话咨询的可行性和影响。

方法

PCP通过电子邮件自愿与一组精神科医生建立联系。建立联系后,鼓励PCP通过短信或电子邮件联系精神科医生,为患者护理安排每月电话咨询。

结果

共有7名PCP和5名精神科医生参与了该项目。PCP与精神科医生通过电话咨询共讨论了66名患者,其中11名患者被转介至精神科进行进一步评估。参与该试点的7名PCP转介至精神科门诊服务的患者数量从2021年11月至2022年10月期间的83例降至本项目期间(即2022年11月至2023年10月)的53例。由于工作繁忙,在安排咨询方面最初存在挑战。经过最初几个月的每月定期联系后,三名精神科医生报告称与PCP的持续联系减少,PCP根据需要通过电子邮件与他们联系。一年后,两名精神科医生继续与指定的PCP保持4至6周的持续联系,平均讨论3至4名患者。精神科医生认为电话会议富有成效,PCP对所提供的支持表示感激,并愿意接管一些由精神科医生护理但有医疗需求且没有PCP的患者的初级护理。

结论

该试点QI项目证实了PCP与精神科医生通过每月电话进行合作的可行性和成功性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0535/12323526/6fe506358ad3/bmjoq-14-3-g001.jpg

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