某三甲儿童医院门诊多学科协作诊疗特点与服务模式探索  

Characteristics and service model exploration of outpatient multidisciplinary collaborative diagnosis and treatment in a Grade III Level A children's hospital

作　　者：姚洁[1] 温婵[1] 张彦各 赵紫薇 杨帆[1] 崔晓薇[1] YAO Jie;WEN Chan;ZHANG Yan'ge;ZHAO Ziwei;YANG Fan;CUI Xiaowei(Hebei Children's Hospital,Shijiazhuang,Hebei Province,050031,PRC)

机构地区：[1]河北省儿童医院,河北省石家庄市050031

出　　处：《中国医院》2024年第7期87-90,共4页Chinese Hospitals

基　　金：河北省医学科学研究课题计划(20230176)。

摘　　要：目的:总结儿童专科医院门诊多学科协作诊疗(MDT)的特点,探索适合儿童医院的门诊MDT服务模式。方法:组建门诊多学科会诊专家团队,制定门诊多学科会诊制度与流程图,会诊流程标准化,门诊部设专人负责组织专家开展门诊MDT,建立门诊多学科会诊病例资料库,登记患者姓名、年龄、会诊原因、申请会诊途径、疾病转归等内容。结果:2021年6月至2023年3月共开展门诊MDT会诊220例。年龄段分布特点,大于5岁患儿107例(48.6%),占比最高;从申请门诊MDT原因统计,需要明确诊断150例(68.2%)是门诊MDT申请的首要原因;网络预约205例(93.2%)是最重要途径,现场分诊和首诊科室申请是次要途径;实施多学科会诊前,专科门诊就诊一次病例数123例(55.9%),就诊3次及以上60例(27.3%);患者转归结果显示,120例(54.5%)患儿痊愈,46例(20.90%)患儿治疗后好转;门诊满意度比较,2020-2022年门诊满意度逐年增高(P<0.01);患儿疾病涉及多系统133例(60.5%),疾病涉及一个系统的患儿87例(39.5%)。结论:儿童专科医院门诊MDT能充分发挥各科专业优势,实现跨学科专业互补及优势学科的强强联合,有利于疾病早期发现、精准诊断;“一站式”诊疗服务模式,优化了就诊流程,提高了就诊效率,改善了就医体验,提升了门诊患者满意度。Objective:To summarize the characteristics of outpatient multidisciplinary collaborative diagnosis and treatment(MDT)in a specialized children's hospital and explore a suitable outpatient MDT service model for children's hospitals.Methods:An expert team for outpatient multidisciplinary consultation was established,an outpatient multidisciplinary consultation system and process chart were formulated,and the consultation process was standardized.The outpatient department assigned personnel to organize experts to conduct outpatient MDTs,and established a database for outpatient multidisciplinary consultation cases,registering patient names,ages,reasons for consultation,consultation application methods,and disease outcomes.Results:From June 2021 to March 2023,a total of 220 outpatient MDT consultations were conducted.Age distribution characteristics showed that 107 cases(48.6%)were children over 5 years old,the highest proportion.The primary reason for applying for outpatient MDT was to clarify the diagnosis 150 cases(68.2%).Online appointments 205 cases(93.2%)were the most important method,while on-site triage and applications from the first consultation department were secondary methods.Before implementing multidisciplinary consultation,123 cases(55.9%)visited a specialist outpatient clinic once,and 60 cases(27.3%)visited three times or more.Patient outcomes showed that 120 children(54.5%)were cured,and 46 children(20.9%)improved after treatment.Outpatient satisfaction increased year by year from 2020 to 2022(P<0.01).Diseases involving multiple systems were found in 133 cases(60.5%),while 87 cases(39.5%)involved a single system.Conclusion:Outpatient MDT in a specialized children's hospital can fully leverage the professional advantages of various departments,achieve interdisciplinary professional complementarity and strong collaboration of superior disciplines,facilitate early detection and accurate diagnosis of diseases,optimize the consultation process,improve consultation efficiency,enhance the medical experienc

关 键 词：儿童医院 医院门诊 多学科协作诊疗 一站式 

分 类 号：R197[医药卫生—卫生事业管理]