Bentley B, DeBehnke D D, Ma O J
Department of Emergency Medicine Medical College of Wisconsin, Milwaukee 53226, USA.
Acad Emerg Med. 1994 Mar-Apr;1(2):1116-20.
For educational purposes, the Residency Review Committee for Emergency Medicine requires that emergency medicine residencies "provide a mechanism for each resident to obtain information on outcomes of patients the resident has evaluated in the emergency department." The authors analyzed the current patient follow-up systems of emergency medicine residencies and, based upon survey results propose a comprehensive organized system of follow-up.
The 84 emergency medicine residency directors listed in the 1991 Society for Academic Emergency Medicine Handbook were polled regarding the current follow- up systems at all hospitals affiliated with their residencies. The survey contained 11 items, including two five-point Likert scales for rating system effectiveness and satisfaction. A description of each hospital's follow-up system was requested, and other comments were reviewed.
The 72 (86%) respondents represented residencies with a total of 138 affiliated hospitals, of which 89 (64.5%) had formal follow-up systems. Of those 89 hospitals, 39% (n = 80) residency directors reported that fewer than half of their residents used the systems, 63% (n = 87) had mandatory compliance policies; 53% had the capability for residents to obtain discharge summaries on admitted patients; and 66% (n = 83) had mechanisms for follow-up of patients released from the emergency department. Twenty-three percent of the systems were considered effective, with ratings of 4 or higher and only 31% received satisfaction ratings of 4 or more.
Most emergency residency-affiliated hospitals in our survey had follow-up systems in place. Of existing systems, only a minority were rated by residency directors as effective or satisfactory. A model for a comprehensive system of patient follow-up is proposed.
出于教育目的，急诊医学住院医师评审委员会要求急诊医学住院医师培训项目“提供一种机制，使每位住院医师能够获取其在急诊科评估过的患者的治疗结果信息”。作者分析了急诊医学住院医师培训项目当前的患者随访系统，并根据调查结果提出了一个全面、有条理的随访系统。
对1991年学术急诊医学协会手册中列出的84位急诊医学住院医师培训项目主任进行了调查，了解其所在培训项目附属的所有医院当前的随访系统。该调查问卷包含11个项目，包括两个用于评估系统有效性和满意度的五分制李克特量表。要求对每家医院的随访系统进行描述，并对其他意见进行审查。
72位（86%）受访者代表了总共138家附属医院的住院医师培训项目，其中89家（64.5%）有正式的随访系统。在这89家医院中，39%（n = 80）的住院医师培训项目主任报告称，使用这些系统的住院医师不到一半；63%（n = 87）有强制遵守政策；53%有能力让住院医师获取入院患者的出院小结；66%（n = 83）有对从急诊科出院患者进行随访的机制。23%的系统被认为是有效的，评分为4分或更高，只有31%的系统满意度评分为4分或更高。
在我们的调查中，大多数急诊住院医师培训项目附属医院都有随访系统。在现有系统中，只有少数被住院医师培训项目主任评为有效或令人满意。本文提出了一个全面的患者随访系统模型。
