La consulta única o de alta resolución como una alternativa de eficiencia a las consultas externas hospitalarias tradicionales

Efficacy of a high-resolution consultation system in gastroenterology at an Andalusian hospital center

“…Our results show that gastroenterology consultations may largely benefit from a HRC system, thus being consistent with previous results (2,3). We see, however, that the percentage of patients that may end up with a diagnosis and treatment all in the same day is significantly lower when compared to other specialties (2,4,5). These findings are logical given the characteristics of subjects with digestive complaints, who often need diagnostics tests requiring prior preparation beyond a fasting state (colonoscopy, colon CT, etc.)…”

“…More than a decade back our hospital implemented an HRC or single consultation system defined as "an ambulatory process of assistance wherein a diagnosis and treatment are established and recorded all on the same day and with a duration previously agreed upon by the user after being timely informed" (2). The organizational novelty of this system is that patients, once assessed by a specialist during a first visit, may, when appropriate, undergo the indicated diagnostic tests and have them reviewed by that same specialist on the same day.…”

“…In the scientific literature the experience with this type of outpatient consultations and their impact on the health care of patients with digestive diseases in our country is very sparse (2,4). These studies suggest that single-day care for outpatients with digestive complaints is below the level observed in other medical specialties (2,(4)(5)(6). Recently, a multicenter study pointed out which structural and organizational requirements were deemed key by gastroenterologists for such ambulatory consultations (7).…”

Non-compliance with appointments amongst patients attending an Allergology Clinic, after implementation of an improvement plan

“…In this Unit we tend to use a single appointment (SA), defined as "an outpatient care service in which a diagnosis is established together with its corresponding treatment, after performing complementary procedures as required, all recorded in a clinical report. All these activities are performed on the same day and within a time that is accepted by the user" 16 . The aim of the system is to incorporate any specialist consultation into a single visit, including a clinical assessment of the patient (history and physical examination), and any complementary procedures that are required in order to establish the diagnosis and subsequent treatment for the reason that the patient has attended the appointment.…”

Nuevas posibilidades organizativas en la era de la historia clínica electrónica

“…Sin embargo, la solución de los problemas de salud en un único acto exige cambios culturales sustanciales: debe de ir precedida de una modificación social del concepto tradicional de la primera visita al especialista (contacto en el que se generan peticiones de pruebas complementarias y se fija una fecha para la revisión de los resultados); bajo el formato de alta resolución el usuario (y el profesional) invierte más tiempo del previsto en la consulta, pero evita nuevas visitas. Si bien los beneficios para los usuarios parecen incuestionables (menor número de jornadas necesarias para completar un diagnóstico, interlocución con un único profesional, evitación de la ansiedad relacionada con la espera del resultado…) 9 , la satisfacción con este esquema todavía no es universal. Obviamente, la institución debe estar comprometida con el formato asistencial, del mismo modo que los profesionales con participación directa.…”