Fletcher R H, Fletcher S W
J Med Educ. 1976 Aug;51(8):634-43.
University teaching hospitals have become increasingly aware of their responsibility to improve both the teaching of ambulatory care and the quality of care provided in their clinics. This paper describes how one department of medicine met this challenge by forming a "Medical Polyclinic." The majority of the department's faculty and house staff, at all academic and training levels, participate in a system of ambulatory care with the following objectives: each patient has a single physician whom he sees by appointment and who coordinates his care; all medical subspecialties are available in the same clinic session; the clinic is attractive and efficient. While these goals are not infrequently met in private group practices, they are unusual in a university teaching hospital, where faculty, house staff, students, and patients each have unique needs, not always compatible. The success and problems of the polyclinic approach are discussed.
大学教学医院越来越意识到它们有责任改善门诊护理教学以及提高其诊所提供的护理质量。本文描述了一个医学系如何通过组建“综合门诊部”来应对这一挑战。该系的大多数教员和住院医师,无论处于何种学术和培训水平,都参与到一个门诊护理体系中,其目标如下:每位患者都有一位指定的医生,由该医生安排就诊并协调其护理;在同一门诊时段内可提供所有医学亚专业的服务;诊所环境宜人且高效。虽然这些目标在私人团体诊所中并不罕见,但在大学教学医院中却不常见,因为教员、住院医师、学生和患者都有各自独特的需求,而且这些需求并不总是相互兼容的。文中讨论了综合门诊部模式的成功之处与问题所在。