Gui G P, Allum W H, Perry N M, Wells C A, Curling O M, McLean A, Oommen R, Sullivan M, Denton S, Carpenter R
Breast Unit, St Bartholomew's Hospital, West Smithfield, London, UK.
J R Soc Med. 1995 Jun;88(6):330-3.
The efficient delivery of health care requires vigilant quality assurance. We describe the audit of our symptomatic breast clinic, which includes the option of a one-stop diagnostic service. A total of 134 new and 386 follow-up patients attended over four consecutive clinics. The majority of new referrals (68%) were seen by a consultant surgeon. Urgent referrals were seen significantly sooner than routine referrals (P < 0.001, chi 2-test), and the mean wait from designated appointment to seeing the surgeon was 37.6 (range-68 to 171) min. One-stop investigations were offered to 50 patients; of these, 36 women (72%) had a total wait of less than 2 h. For those not investigated at the same clinic, the mean time until investigations was 6.1 (range 0-36) days and mean recall was 2.7 (range 1-8) weeks. Patients undergoing definitive surgery for cancer (n = 5) were operated on average 14.2 (range 7-27) days after the decision was made in outpatients, while the mean waiting time for non-cancer operations was 49.7 (range 15-98) days. Objective audit on outpatient services is possible and can lead to improvement of services.
高效提供医疗保健需要严格的质量保证。我们描述了对我们有症状乳腺诊所的审核情况，其中包括一站式诊断服务选项。在连续的四家诊所中，共有134名新患者和386名随访患者就诊。大多数新转诊患者（68%）由外科顾问医生诊治。紧急转诊患者的就诊时间明显早于常规转诊患者（P < 0.001，卡方检验），从指定预约到见到外科医生的平均等待时间为37.6（范围为68至171）分钟。为50名患者提供了一站式检查；其中，36名女性（72%）的总等待时间少于2小时。对于那些未在同一诊所接受检查的患者，直到进行检查的平均时间为6.1（范围为0至36）天，平均召回时间为2.7（范围为1至8）周。接受癌症根治性手术的患者（n = 5）在门诊做出决定后平均14.2（范围为7至27）天接受手术，而非癌症手术的平均等待时间为49.7（范围为15至98）天。对门诊服务进行客观审核是可行的，并且可以改进服务。
