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首頁(yè)> 外文期刊>BMC Nephrology >The British Columbia Nephrologists’ Access Study (BCNAS) – a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations
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The British Columbia Nephrologists’ Access Study (BCNAS) – a prospective, health services interventional study to develop waiting time benchmarks and reduce wait times for out-patient nephrology consultations

機(jī)譯：不列顛哥倫比亞省腎臟病專家訪問(wèn)研究（BCNAS）–前瞻性，健康服務(wù)干預(yù)性研究，用于制定等待時(shí)間基準(zhǔn)并減少門診腎臟病咨詢的等待時(shí)間

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Background Early referral and management of high-risk chronic kidney disease may prevent or delay the need for dialysis. Automatic eGFR reporting has increased demand for out-patient nephrology consultations and in some cases, prolonged queues. In Canada, a national task force suggested the development of waiting time targets, which has not been done for nephrology. Methods We sought to describe waiting time for outpatient nephrology consultations in British Columbia (BC). Data collection occurred in 2 phases: 1) Baseline Description (Jan 18-28, 2010) and 2) Post Waiting Time Benchmark-Introduction (Jan 16-27, 2012). Waiting time was defined as the interval from receipt of referral letters to assessment. Using a modified Delphi process, Nephrologists and Family Physicians (FP) developed waiting time targets for commonly referred conditions through meetings and surveys. Rules were developed to weigh-in nephrologists’, FPs’, and patients’ perspectives in order to generate waiting time benchmarks. Targets consider comorbidities, eGFR, BP and albuminuria. Referred conditions were assigned a priority score between 1-4. BC nephrologists were encouraged to centrally triage referrals to see the first available nephrologist. Waiting time benchmarks were simultaneously introduced to guide patient scheduling. A post-intervention waiting time evaluation was then repeated. Results In 2010 and 2012, 43/52 (83%) and 46/57 (81%) of BC nephrologists participated. Waiting time decreased from 98(IQR44,157) to 64(IQR21,120) days from 2010 to 2012 (p?=? Conclusions An integrated, Provincial initiative to measure wait times, develop waiting benchmarks, and engage physicians in active waiting time management associated with improved access to nephrologists in BC. Improvements in waiting time was most marked for the highest priority patients, which suggests that benchmarks had an influence on triaging behavior. Further research is needed to determine whether this effect is sustainable.
機(jī)譯：背景早期轉(zhuǎn)診和管理高危慢性腎臟病可能會(huì)阻止或延遲透析的需要。自動(dòng)eGFR報(bào)告增加了對(duì)門診腎臟病咨詢的需求，在某些情況下，排隊(duì)的時(shí)間也越來(lái)越長(zhǎng)。在加拿大，一個(gè)國(guó)家工作隊(duì)建議制定等待時(shí)間目標(biāo)，但腎臟病專家尚未這樣做。方法我們?cè)噲D描述不列顛哥倫比亞?。˙C）的門診腎臟病咨詢的等待時(shí)間。數(shù)據(jù)收集分兩個(gè)階段進(jìn)行：1）基準(zhǔn)描述（2010年1月18日至28日）和2）等待時(shí)間基準(zhǔn)介紹（2012年1月16日至27日）。等待時(shí)間定義為從收到推薦信到評(píng)估的間隔時(shí)間。腎臟病學(xué)家和家庭醫(yī)師（FP）使用經(jīng)過(guò)改進(jìn)的Delphi程序，通過(guò)會(huì)議和調(diào)查為普遍推薦的疾病制定了等待時(shí)間目標(biāo)。制定規(guī)則以權(quán)衡腎病學(xué)家，F(xiàn)P和患者的觀點(diǎn)，以生成等待時(shí)間基準(zhǔn)。目標(biāo)人群考慮合并癥，eGFR，BP和蛋白尿。推薦的條件在1-4之間分配了優(yōu)先級(jí)。鼓勵(lì)不列顛哥倫比亞省的腎臟科醫(yī)生集中分診轉(zhuǎn)診，以看望第一位可用的腎臟科醫(yī)生。同時(shí)引入了等待時(shí)間基準(zhǔn)來(lái)指導(dǎo)患者調(diào)度。然后重復(fù)干預(yù)后的等待時(shí)間評(píng)估。結(jié)果2010年和2012年，不列顛哥倫比亞省的腎病學(xué)家參加了43/52（83％）和46/57（81％）。從2010年到2012年，等待時(shí)間從98（IQR44,157）天減少到64（IQR21,120）天（p？=？）結(jié)論：該省采取綜合措施來(lái)衡量等待時(shí)間，制定等待基準(zhǔn)并讓醫(yī)生參與積極的等待時(shí)間管理與改善卑詩(shī)省腎臟病醫(yī)生的聯(lián)系有關(guān)，對(duì)于優(yōu)先級(jí)最高的患者，等待時(shí)間的改善最為明顯，這表明基準(zhǔn)對(duì)分診行為有影響，需要進(jìn)一步研究以確定這種作用是否可持續(xù)。

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