Analysis and management strategy of inter-departmental general consultation

Abstract

Objective To explore characteristics of general inter-departmental consultations in a hospital and put forward management strategy suggestions. Methods A large tertiary general hospital in Beijing was cited as the research object. Data were extracted from the EMR of the in-hospital inter-departmental consultations from July 1, 2017 to June 30, 2018, including information such as applying departments, submission time, invited departments, consultation completion time among others. Also collected were data such as discharges, case combination index(CMI), and preoperative average hospitalization days of clinical departments. Pearson and Spearman methods were used to perform correlation analysis, and independent sample Wilcoxon rank sum test was performed for the mean comparison. Results The ratio of consultations to discharged patients was 0.44, while consultation workload of cardiovascular medicine, ophthalmology and neurology was higher, and consultation applications issued by neurology, rheumatology and endocrinology departments were higher.For surgical departments, the correlation between demand of consultations and CMI was strong, r=0.63(P<0.05). The completion rate of consultation within 24 hours was 90.08%, and 64.79% of overtime consultations were caused by 35.63% of the consultation physicians. Conclusions It is imperative to enhance infrastructure support and information system construction to meet huge demands of inter-departmental consultations and to ensure patient safety; To further examinations of consultation purposes and improve doctors′ integrative abilities of diagnosis and treatment by introducing HIM mode to the training system, for the purpose of reducing unnecessary consultations; Optimize the process, shorten preoperative average length of stay by bringing forward inpatient-consultations to outpatient department; Inspire consultation enthusiasm and ensure consultation quality through performance appraisal mechanism. Key words: Case management; Consultation; Case mix index; Holistic integrative medicine; Efficiency