EFFICACY OF A TELEPHONE FOLLOW-UP SYSTEM IN THE EMERGENCY DEPARTMENT
EFFICACY OF A TELEPHONE FOLLOW-UP SYSTEM IN THE EMERGENCY DEPARTMENT
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DOI：
10.1016/0736-4679(88)90336-8
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发表时间：
1988-01-01
影响因子：
1.5
通讯作者：
DOUGHERTY J
中科院分区：
文献类型：
--
作者：
JONES J;CLARK W;DOUGHERTY J
传统上，急诊科的治疗以简短的医患接触、零散的服务和缺乏后续护理而闻名。这种氛围可能导致患者不满，并可能导致出院指示和药物的高不依从率。为了科普这个问题，一项前瞻性研究，旨在评估电话随访系统及其对病人护理和满意度的影响。在1个月的时间内，每天审查所有急诊科图表，并选择约15%进行重新联系。这些图表是使用由急诊医生制定的20项标准的详细列表选择的。由急诊科医生、护士或社会工作者在患者就诊后的第二天拨打电话。根据工作人员（医生、护士、社会工作者）的专业知识和培训范围内的预定标准，将呼叫分配给他们。我们能够接触到81%（229/281）的选择再次接触的患者。这些电话的目的是询问患者临床状态的变化，加强出院指导，并确定任何患者对治疗的投诉。平均拨打1.6个电话才能成功联系到每位患者。这些电话平均持续70秒。在联系的患者中，42%（97/229）需要进一步澄清其出院说明。这些电话导致大多数患者（6/7）直接接受医疗干预，这些患者称其临床状况恶化。95%的患者（112/118）认为电话有用。我们的结论是一个后续的呼叫系统，为选定的病人是一个有效的方法，表现出病人的关注，提高质量保证，并提供有用的反馈给急救人员。该系统现已成为我们质量保证计划的永久组成部分。
Traditionally, treatment in the emergency department is noted for brief doctor-patient encounters, fragmented service, and lack of follow-up care. This atmosphere can lead to patient dissatisfaction and may contribute to the high rate of noncompliance with discharge instructions and medications. To cope with this problem, a prospective study was designed to evaluate a telephone follow-up system and its effect on patient care and satisfaction. During a 1-month period, all emergency department charts were reviewed daily, and approximately 15% were selected for recontact. These charts were selected using a detailed list of 20 criteria developed by staff emergency physicians. Calls were made by an emergency department physician, nurse, or social worker on the day following the patient's visit. Calls were assigned to staff members (physician, nurse, social worker) on the basis of preestablished criteria within the spectrum of their expertise and training. We were able to reach 81% (229/281) of the patients selected for recontact. The purpose of these calls was to question patients about changes in clinical status, reinforce discharge instructions, and identify any patient complaints about treatment. An average of 1.6 calls were made to successfully contact each patient. The calls lasted an average of 70 seconds. Of the patients contacted 42% (97/229) required further clarification of their discharge instructions. The calls resulted in direct medical intervention in the majority of patients (6/7) who stated their clinical condition had worsened. Ninety-five percent of the patients questioned (112/118) felt that the call was useful. We conclude that a follow-up call system for selected patients is an effective method for demonstrating patient concern, improving quality assurance, and providing useful feedback to the emergency staff. This system is now a permanent part of our quality-assurance program.