米尔顿凯恩斯大学医院护士主导的炎症性肠病门诊中临床医师和患者支持工具的影响审计

Lianne Lewis, Callum Michie, Alexander Sheppard, Millicent Stone, George Macfaul, Joe Harrison
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引用次数: 0

摘要

目的该审计检查了最近委托开发的临床医生和患者支持工具对米尔顿凯恩斯大学医院炎症性肠病患者护理路径、随访预约(包括 PIFU)、相关成本节约以及患者和临床医生参与度和体验的影响。设计在为期 9 个月的审计期间,对 iOWNA 平台注册患者的预约记录进行了回顾性连续病例审查。患者与医生的互动根据是否节省了预约时间进行分类,并记录适当的护理时间节省情况。此外,还从信托机构收集了有关成本节约和 PIFU 数量的数据。还收集了临床医生和患者体验的定量和定性反馈。结果在整个审计期间,iOWNA 的部署总共节省了 14,735 分钟的时间,其中 9,280 分钟是节省的面诊时间,即节省了 232 次预约。这 232 次预约节省的费用共计 16 704 英镑。在审计期间,患者主动随访 (PIFU) 的数量也有了显著增加(p<0.01)。患者和临床医生调查显示,所有服务对象都对新的护理路径给予了积极评价。审计结果表明,数字工具在改造现有护理路径以应对 COVID-19 大流行后国家医疗服务体系面临的广泛挑战方面可以发挥重要作用,如果在全国范围内减少 5%的门诊就诊人次的同时复制本次审计中节省的预约成本,那么国家医疗服务体系每年可节省超过 3.45 亿英镑。
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Audit of Impact of a Clinician & Patient Support Tool in a Nurse-led Clinic for Inflammatory Bowel Disease Service at Milton Keynes University Hospital
Objective This audit examines the impact of a recently-commissioned clinician and patient support tool, on care pathways for Inflammatory Bowel Disease patients at Milton Keynes University Hospital, on follow up appointments (including PIFUs), associated cost savings and patient and clinician engagement and experience. Design The audit was conducted using a retrospective, consecutive case review of appointment records of patients enrolled onto the iOWNA platform during a 9-month audit period. Patient-clinician interactions were categorised depending on whether an appointment was saved and an appropriate nursing time saving logged. Data on both cost savings and PIFU numbers were also collected from the trust. Quantitative and qualitative feedback of clinician and patient experience were captured. Results The deployment of iOWNA resulted in a total time saving of 14,735 minutes across the audit period, of which 9,280 minutes comprised savings on in-person appointments, representing 232 appointments saved. The cost savings for these 232 replaced appointments totalled 16,704 GBP. The audit period also saw a statistically significant (p<0.01) increase in the number of Patient-Initiated Follow Ups (PIFUs). Patient and clinician surveys reflected positive experiences of the new care pathway among all service users. Conclusion The results of the audit demonstrate the important role digital tools can play in transforming existing care pathways to deal with the widespread challenges facing the NHS following the COVID-19 pandemic, with annual savings of over 345 million GBP for the NHS if the appointment cost savings demonstrated in this audit were replicated alongside a 5% reduction nationally in outpatient attendances.
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