METHODS: The clinic was implemented in four health services in Melbourne, Australia across a six-month period in 2018. Evaluation was by prospective data collection of the frequency and characteristics of patients who used the service, pre- and post-survey of patient reported experience, and a post-implementation survey of clinician engagement and experience.
RESULTS: There were 3095 patient encounters in the six-month implementation period; 136 patients were directly admitted to inpatient healthcare services after clinic utilization. Of patients who contacted SURC (n = 2174), a quarter (n = 553) stated they would have otherwise presented to the emergency department and 51% (n = 1108) reported they would have otherwise called the Day Oncology Unit. After implementation, more patients reported having a dedicated point of contact (OR 14.3; 95% CI 5.8-37.7) and ease of contacting the nurse (OR 5.5; 95% CI 2.6-12.1). Clinician reported experience and engagement with the clinic was highly favorable.
CONCLUSIONS: The nurse-led emergency department avoidance model of care addressed a gap in service delivery, while optimizing service utilization by reducing ED presentations. Patients reported improved levels of satisfaction with ease of access to a dedicated nurse and advice provided.
方法:该诊所在墨尔本的四个卫生服务机构中实施,澳大利亚在2018年的六个月期间。评估是通过前瞻性数据收集使用该服务的患者的频率和特征,患者报告体验调查前后,以及临床医生参与和经验的实施后调查。
结果:在6个月的实施期内,有3095名患者相遇;136名患者在诊所使用后直接进入住院医疗服务。在接触SURC的患者中(n=2174),四分之一(n=553)表示他们本来会向急诊科就诊,而51%(n=1108)表示他们本来会被称为Day肿瘤科。实施后,更多患者报告有专门的接触点(OR14.3;95%CI5.8~37.7),且易于与护士联系(OR5.5;95%CI2.6~12.1).临床医生报告说,经验和对诊所的参与非常有利。
结论:护士主导的急诊科回避护理模式解决了服务提供方面的差距,同时通过减少ED演示文稿来优化服务利用率。患者报告满意度提高,易于获得专职护士和提供建议。