Implementation of Collection of Patients' Disability Status by Centralized Scheduling
Implementation of Collection of Patients' Disability Status by Centralized Scheduling
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DOI：
10.1016/j.jcjq.2021.05.007
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发表时间：
2021-09-21
影响因子：
2.3
通讯作者：
Wong, Alicia A.
中科院分区：
文献类型：
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作者：
Morris, Megan A.;Hamer, Mika K.;Wong, Alicia A.
背景资料：收集电子健康记录（EHR）中的残疾状态对于解决残疾患者所经历的重大医疗保健差异至关重要。尽管如此，很少有证据存在，以通知implementation.Methods：这项试点试验评估的实施情况，收集病人的残疾状况在初级保健新的病人登记由集中呼叫中心的工作人员。这项研究在科罗拉多的一个学术医院系统进行了六个多星期。工作人员接受了30分钟的培训，内容是如何在电子健康记录中询问和记录残疾状况。通过病历审查和患者登记电话记录评估收集完成率、保真度和一致性。焦点小组与工作人员和电话采访患者评估的经验，包括残疾筛查在patient registration.Results：在研究期间，共有3,673名新患者在53个初级保健诊所之一登记。EHR中残疾状态的完成率从基线时的9.5%增加到试验最后一周的53.5%，然后保持8周。在录音电话中确定了挑战，并忠实地询问了问题是否和如何提出。没有病人投诉的报告，和病人报告没有关注残疾状态的收集在interviews.Conclusion：记录残疾状态在患者登记是有效的，是不关心病人。为了采取初步措施提供公平的护理，应努力在整个临床过程中普遍实施这种类型的筛查。
Background: Collection of disability status in electronic health records (EHRs) is critical to addressing the significant health care disparities experienced by patients with disabilities. Despite this, little evidence exists to inform implementation.Methods: This pilot trial evaluated the implementation of collection of patients' disability status during primary care new patient registration by centralized call center staff. The study took place over six weeks at an academic hospital system in Colorado. Staff received a 30-minute training on how to ask and document disability status in the EHR. Completion rate of collection, fidelity, and concordance were assessed through chart reviews and recordings of patient registration calls. Focus groups with staff and phone interviews with patients assessed the experience of including disability screeners in patient registration.Results: A total of 3,673 new patients were registered at one of the 53 primary care clinics during the study period. Completion of disability status in the EHR increased from 9.5% at baseline to 53.5% by the last week of the trial, which was then maintained for eight weeks. Challenges were identified in the recorded calls with fidelity of if and how the questions were asked. No patient complaints were reported, and patients reported no concerns regarding collection of disability status during interviews.Conclusion: Documenting disability status during patient registration was effective and was not concerning to patients. To make initial steps to providing equitable care, efforts should be made to implement this type of screening universally across the clinical encounter.