Quelles solutions pour la garde en médecine générale? - KCE

112
Items
Data sources on after-hours care in United Kingdom
8.4.2.1. Weebsites
At the initial ccontact
stage and at th he end of triage, calls need to be prioritised into three different caategories
– emergencyy,
urgent and routine. IIn
order to report whetther
the time standards
in the National Quality Requirementss
are being met, the sooftware
application neeeds
to record the timee
intervals between diffferent
stages, e.g. reccord
the time taken
between a call being g answered and definitive
triage being condducted.
These prioritiisations
and the asso ociated time need to bbe
immediately visible at subsequent stages,
so that for examplee
a clinician at the triaage
stage can see whhich
calls have beeen
designated urgent,
which are routine and
how long each call hhas
been waiting in orrder
to determine whicch
call they should triaage
next.
Search, retrieeval
and reporting of in nformation held within the database
Each time a ppatient
contacts the se ervice, the system neeeds
to be able to find aany
earlier informationn
held about this persoon,
e.g. any special nootes
provided by their GP
or any past ccontact
with the servi ice. In order to reportt
on the National Quaality
Requirements thee
system has to prodduce
the necessary data
to show whether the
relevant standards
have been met t. The system will alsoo
record and report onn
the activities of stafff,
e.g. length of time sspent
on triage calls by
each clinician. Natioonal
Quality Requuirement
4 specifies auditing a requirements;
these audits will moost
commonly be connducted
using the Royyal
College of GPs ( RCGP) audit toolkit. It is
possible to mmanually
conduct these e audits but the processs
can be made more efficient by using an iin-built
audit toolkit.
Compatibility y with other telephone systems and mobile ddevices
Providers of software for after-hou urs services will oftenn
offer a telephone syystem
as part of their
software. If a differeent
telephone systemm
is used, the after-hoours
software has to be compatible with h this. The telephone ssystem
must also fulfilll
basic requirements ssuch
as being able to record phone calls annd
details, and being aable
to record thee
information necessar ry to report against National
Quality Requirement
8. Given the nneed
for clinical staff to conduct home visitts
the software has too
be
compatible wwith
mobile devices (i.e e. laptops) to allow clinnicians
to view and enter
notes while travelliing
to and from home visits.
http://www.cqc.orrg.uk
http://www.nhsddirect.nhs.uk/About/WhatIsNHSDirect
http://www.eurAAHnet.eu/index.phhp?option=com_c
content&view=articcle&id=22
&Itemid=24
http://www.out-oof-hours.info/docuuments.php
http://www.euroo.who.int/__data/aassets/pdf_file/000
04/135148/e94836.pdf
8.4.2.2. Refferences
1. Hallam L. Primary medical ccare
outside norm mal working hourss:
review of
published wwork.
BMJ 1994; 308: 249-53.
2. Ale J, Shippman
C, Lacock I, , Davies M. Creat ting a shared visioon
of out of
hours care.
BMJ 1996; 312: 1206-10.
3. Heaney DD,
Gorman,D. AAuditing
of out- -of-hours primaryy
medical
care.Healthh
Bulletin 1996; 544(6):495-8.
4. Murphy A, , Bury G, Plunkeett
P, et al. Ran ndomised controlled
trial of
general praactitioner
versus usual medical care
in an urban acccident
and
Affter-Hours
Primaary
Care
5.
6.
7.
8.
9.
Results
KCE Reportss
171
emergency depaartment:
process,
outcome and ccomparative
cost. BMJ
1996; 312: 11355-42.
Cragg D, McKKinley
R, Oland M, Campbell SS,
Hastings M, eet
al.
Comparison pf out of hours caare
provided by patients’ own geeneral
practitioners annd
commercial deputizing servvices:
a randommized
controlled trial I: The process of care.
BMJ 1997; 314:
187-9.
Jessopp L, Beckk
I, Hollins L, Reyynolds
M, Dale J. . Changing the paattern
out of hours: a ssurvey
of general practice cooperaatives.
BMJ 1997; ; 314:
199-200.
McKinley R, Maanku-Scott
T, Hasstings
A, French D, Baker R. Reliaability
and validity of a new measure oof
patient satisfacction
with out of hhours
primary medicall
care in the Unitted
Kingdom: devvelopment
of a patient
questionnaire. BBMJ
1997; 314: 1339-8.
Salisbury C. Evaaluation
of a geneeral
practice out oof
hours cooperative:
a
questionnaire suurvey
of general ppractitioners.
BMJ 1997; 314: 1598-9.
South Wiltshire Out of Hours prooject
(SWOOP) Group.
Nurse telepphone
triage in out of hours
primary caree:
a pilot study. BMMJ
1997; 314: 1988-9.