Document Detail


Improving the organization of consultation departments in university hospitals.
MedLine Citation:
PMID:  18070264     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: Changes in the demography of doctors require changes in care practices. OBJECTIVES: The aim of this study was to identify factors associated with doctors' workload in the ophthalmology consultation department of a university hospital, with a view to developing methods to improve the organization of hospital outpatient clinics. METHODS: A 10-day cross-sectional survey was carried out in an ophthalmology outpatient clinic (in- and outpatient consultations, including emergencies) specializing in the uveitis care. Demographic and management data for each patient were collected on a structured form. The doctor's workload was assessed, using a scale taking into account the duration of the consultation and the number of diagnostic tests performed, as a function of management complexity. RESULTS: Of the 861 consultations studied, 39.7% were highly complex. The level of complexity of consultations was correlated with the type of referral (phi = 0.602), consultation duration (phi = 0.545), the number of consultations in the previous year (phi = 0.499), and the number of diagnostic tests performed (phi = 0.445). Consultations were longer and diagnostic tests were more frequently performed if patients had been referred by an ophthalmologist, consulted a faculty doctor or a fellow, or presented with uveitis. Consultations were also more complex for patients with at least four previous consultations in the past year. CONCLUSIONS: Type of referral, status of the attending doctor and number of consultations within the course of 1 year were associated with doctors' workload and could be taken into account to predict the duration of complexity of consultations when scheduling appointments.
Authors:
Agnès Dechartres; Valérie Mazeau; Catherine Grenier-Sennelier; Antoine P Brézin; Gwenaelle M Vidal-Trecan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  13     ISSN:  1356-1294     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-11     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  930-4     Citation Subset:  IM    
Affiliation:
Service de Santé Publique, Groupe Hospitalier Cochin Saint Vincent de Paul (Assistance Publique - Hôpitaux de Paris), Université Paris Descartes, Faculté de Médécine, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aged
Appointments and Schedules
Cataract / diagnosis
Child
Cross-Sectional Studies
Diagnostic Techniques, Ophthalmological
Eye Diseases / diagnosis
Female
Hospital Departments / organization & administration*
Hospitals, University / organization & administration*
Humans
Male
Middle Aged
Muscle Hypertonia / diagnosis
Oculomotor Muscles / physiopathology
Ophthalmology / organization & administration*
Outpatient Clinics, Hospital / organization & administration
Referral and Consultation / organization & administration*
Refractive Errors / diagnosis
Time Factors
Uveitis / diagnosis
Workload

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