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通过 ambulatory safety net 的协作来降低延迟结肠直肠癌诊断的风险.

Rachel Moyal-Smith, Meagan Elam, Jason Boulanger

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    实施大肠直肠癌 (CRC) 查的门诊安全网 (ASN) 成功识别了需要随访的患者,并提高了结肠镜完成率,减少了诊断延迟.

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    科学领域:

    • 改善医疗保健质量 改善医疗保健质量
    • 患者安全 患者安全
    • 结肠直肠癌查 结肠直肠癌查

    背景情况:

    • 由于诊断错误,每年有数百万成年人面临延迟诊断.
    • 门诊安全网 (ASN) 是旨在减轻延迟诊断的干预措施,通过跟踪需要随访的异常结果的患者.
    • 结肠直肠癌 (CRC) 查是ASN实施的关键领域,以防止诊断延迟.

    研究的目的:

    • 共同设计一个合作模式,以实施专注于结直肠癌 (CRC) 的门诊安全网 (ASNs).
    • 制定指导和措施,在各种医疗保健机构建立和维持CRCASN.
    • 评估CRC协作ASN在促进异常查后患者随访方面的有效性.

    主要方法:

    • 一个工作组共同设计了实施指南,措施和协作模型.
    • 六个医疗保健机构参与了为期18个月的突破系列合作,重点是ASN,用于在家进行阳性CRC查或逾期监测结肠镜检查.
    • 每月的数据收集跟踪了患者的联系,安排和完成ASN内的随访结肠镜检查.

    主要成果:

    • 在六个参与站点中,有四个在合作结束时已经有了操作的ASN,剩下的两个在不久之后启动.
    • 合作的ASN在2022年10月至2024年2月期间确定了5165名需要外展后续护理的患者.
    • 在确定的患者中,68.8%的患者被成功联系,39.9%的患者被安排进行结肠镜检查,29.1%的患者完成了手术.

    结论:

    • 协作方法成功识别了异常CRC查结果的患者,并促进了必要的后续结肠镜检查的完成.
    • 开发的CRC ASN实施指南为医疗保健领导人提供了一份路线图,旨在建立类似的安全网.
    • 实施ASNs是一种可行的策略,可以改善患者的随访,并减少结直肠癌治疗中的诊断延迟.