调查门诊服务的创新:混合方法快速评估
Chris Sherlaw-Johnson1, Theo Georghiou1, Sarah Reed1
1Research and Policy, The Nuffield Trust, London, UK.
Health and social care delivery research
|September 27, 2024
概括
患者发起的随访 (PIFU) 允许患者根据需要安排预约,减少不必要的访问. 虽然对工作人员和患者来说总体而言是积极的,但它对结果和工作量的影响需要进一步研究.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 门诊护理创新 门诊护理创新
- 医疗保健管理的管理
背景情况:
- 门诊服务正在探索创新,以改善护理管理和减少预约频率.
- 患者发起的随访 (PIFU) 是一项尚未研究的创新,使患者能够根据需要预订预约,偏离标准时间表.
研究的目的:
- 通过使用国家医院数据,识别英格兰国家卫生服务 (NHS) 实施的门诊创新.
- 在NHS中对PIFU的实施和影响进行快速混合方法评估.
主要方法:
- 一种由四个工作流组成的方法,包括范围审查,数据分析的指标和和医院采访.
- 对PIFU的混合方法评估包括证据审查,与36名临床/运营人员和5个NHS信托机构的4名患者的采访,以及与13个NHS信托机构的研讨会.
- 分析国家和地方数据,并通过开发评估指南来补充.
主要成果:
- 指标和确定了9个服务,后续比率发生了重大变化;采访显示了不同的实施模式和成功因素 (临床状况,IT,员工能力).
- 国家数据分析显示,增加PIFU使用与15个专业的门诊出院率较低以及7个专业的出院率较高之间存在关联.
- 四个专业显示,急诊室的访问减少,PIFU率增加;工作人员和患者对PIFU的看法是积极的,尽管对工作量的影响各不相同.
结论:
- 员工和患者对PIFU的看法是积极的,为国家门诊转型政策和当地实践提供了洞察力.
- 该研究强调了不同环境中PIFU实施,患者选择,监测和出院流程的变化.
- 关于PIFU对个人结果,健康不平等,患者体验,工作量和能力的影响仍然存在不确定性,需要进行地方评估.
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