医疗保健提供者如何在电话选中决定转诊地点:一个横截面研究
Aaron J Fried1, Christine Gladman2, Darren A DeWalt2
1Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. ajfried25@gmail.com.
Journal of general internal medicine
|June 3, 2024
概括
医疗保健提供者的分拣决策有很大的不同,受临床资源,患者因素和临床医生的经验的影响. 了解这些复杂因素是改善患者护理和减少急诊室过度拥挤的关键.
科学领域:
- 医疗保健管理的管理
- 临床决策 - 临床决策
- 医疗 triage 医学分类
背景情况:
- ~25%的急诊室 (ED) 访问是之前与医疗保健专业人员的联系.
- 许多患者可以在非ED的门诊环境中进行管理,改善ED流量和患者体验.
- 了解提供者选决策对于优化护理途径至关重要.
研究的目的:
- 评估医疗保健提供者在患者分拣中的思维过程.
- 确定影响患者呼叫分拣决策的因素.
主要方法:
- 使用假设的临床场景进行横截面调查研究.
- 参与者包括内部医学,家庭医学和急诊医学提供者.
- 对自由响应数据的定性分析确定了关键主题和影响因素.
主要成果:
- 在不同提供者和病例中观察到选决策的显著变化.
- 与住院医生相比,主治医生对ED进行分组的患者较少 (p<0.001).
- 定性数据揭示了复杂的认知过程和影响选的因素.
结论:
- 提供者选决策是多因素的,涉及临床资源,护理协调,患者和临床医师因素.
- 选决策的变化不完全由医生特征单独解释.
- 开发了一种用于认知分类的新概念模型.
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