多专科、多地点医疗实践中的就诊自主排期:复杂性、挑战和成功。

IF 1.5 Q3 HEALTH POLICY & SERVICES Health Services Research and Managerial Epidemiology Pub Date : 2024-05-08 eCollection Date: 2024-01-01 DOI:10.1177/23333928241253126
Frederick North, Rebecca Buss, Elissa M Nelson, Matthew C Thompson, Jennifer Pecina, Gregory M Garrison, Brian A Crum
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引用次数: 0

摘要

背景:就诊自主排期越来越普遍,但就诊自主排期的多重要求非常复杂,阻碍了就诊自主排期的实施。梅奥诊所于 2019 年实施了自主排期,此后一直在增加可自主排期的就诊组合。我们的目的是展示量化与就诊排班相关的复杂性的措施,并描述排班复杂性的机遇和挑战如何应用于自我排班:我们检查了 2022 年 1 月 1 日至 2023 年 8 月 24 日期间的预约就诊情况。对于七个就诊类别,我们统计了所有已安排的独特就诊类型,包括员工安排的和自行安排的。我们对自行安排的访问类型进行了统计,以确定研究期间访问量最高的访问类型:结果:共有 9555 种独特的就诊类型,完成了 2080 万次就诊。自行安排的访问类型占已完成访问总数的 4.0%(838,592/20,769,699)。在七个就诊类别中,自行安排的固定病人就诊、检测就诊和程序就诊占所有自行安排就诊的 93.5%(784,375/838,592)。初级保健中的固定病人就诊(10 种就诊类型)占所有自行安排就诊的 273 007 人次(32.6%)。检测就诊(血液和尿液检测,2 种就诊类型)占所有自行预约就诊的 183,870 人次(21.9%)。乳房 X 光筛查、骨矿物质密度和免疫接种(8 种就诊类型)的程序性就诊占所有自行安排就诊的 147,358 人次(17.6%):结论:大量独特的就诊类型是自我排期的一大挑战。有些就诊类型更适合自行排期。以指南为基础的诊疗程序,如乳房 X 光检查、骨矿物质密度检查和免疫接种,都是诊疗量大的诊疗程序,可以标准化后进行自主排班。固定病人就诊和实验室检测就诊也可以标准化,以便于自行排期。尽管取得了成功,但仍有成千上万种特殊就诊类型可能需要工作人员和排班员的干预才能正确排班。
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Self-scheduling Medical Visits in a Multispecialty, Multisite Medical Practice: Complexity, Challenges, and Successes.

Background: Self-scheduling of medical visits is becoming more common but the complexity of applying multiple requirements for self-scheduling has hampered implementation. Mayo Clinic implemented self-scheduling in 2019 and has been increasing its portfolio of self-schedulable visits since then. Our aim was to show measures quantifying the complexity associated with medical visit scheduling and to describe how opportunities and challenges of scheduling complexity apply in self-scheduling.

Methods: We examined scheduled visits from January 1, 2022, through August 24, 2023. For seven visit categories, we counted all unique visit types that were scheduled, for both staff-scheduled and self-scheduled. We examined counts of self-scheduled visit types to identify those with highest uptake during the study period.

Results: There were 9555 unique visit types associated with 20.8 M (million) completed visits. Self-scheduled visit types accounted for 4.0% (838,592/20,769,699) of the completed total visits. Of seven visit categories, self-scheduled established patient visits, testing visits, and procedure visits accounted for 93.5% (784,375/838,592) of all self-scheduled visits. Established patient visits in primary care (10 visit types) accounted for 273,007 (32.6%) of all self-scheduled visits. Testing visits (blood and urine testing, 2 visit types) accounted for 183,870 (21.9%) of all self-scheduled visits. Procedure visits for screening mammograms, bone mineral density, and immunizations (8 visit types) accounted for 147,358 (17.6%) of all self-scheduled visits.

Conclusion: Large numbers of unique visit types comprise a major challenge for self-scheduling. Some visit types are more suitable for self-scheduling. Guideline-based procedure visits such as screening mammograms, bone mineral density exams, and immunizations are examples of visits that have high volumes and can be standardized for self-scheduling. Established patient visits and laboratory testing visits also can be standardized for self-scheduling. Despite the successes, there remain thousands of specific visit types that may need some staff-scheduler intervention to properly schedule.

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来源期刊
CiteScore
1.60
自引率
6.20%
发文量
32
审稿时长
12 weeks
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