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응급 협의진료 질 평가를 위한 기초 연구

Other Titles
 Evaluation of Emergency Consultation Skill: A Preliminary Study 
Authors
 전승훈 ; 한경화 ; 김민정 ; 박인철 ; 정성필 ; 박유석 ; 유제성 ; 이누가 ; 김현종 ; 김승환 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.24(1) : 89~94, 2013 
Journal Title
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지) 
ISSN
 1226-4334 
Issue Date
2013
Abstract
Purpose: Emergency consultation is a common and important aspect in the emergency department (ED). Kessler et al. suggested the five Cs of the emergency medicine (EM) consulting checklist; contact, communication, core question, collaboration, and closing the loop as a tool for evaluation of consultation quality. The objective of this study was to evaluate the appropriateness of this checklist as a tool for assessment of the skill of requesting consultation in the ED. Methods: This study was conducted in the ED at an urban training hospital. Three emergency physicians recorded telephone conversations when they contacted consultant physicians for consultation regarding emergency patients. After recording files were collected, eight raters evaluated each conversation using the five Cs of the EM consulting checklist. Results: A total of 58 cases were gathered. The most frequent emergency acuity level of patients was 3, by 72.4%. The mean duration of conversation was 53±30 seconds. The mean total score was 41.9±3.1. When the scores for the five Cs` categories were evaluated, the score was lowest, at 2.9±1.0 for ``contact`` and highest, at 4.8±0.5, for ``communication``. Inter-rater agreement (95%confidence interval) of the total score was 0.819 (0.755-0.875). In the case of acuity level 3, the agreement was high, at 0.859(0.796-0.911), whereas it was 0.691 (0.491-0.874) and 0.426(0.115-0.922) in acuity levels 2 and 4, respectively. Conclusion: EM consultations were evaluated according to the five Cs of the EM consulting checklist showing high inter-rater agreement. This checklist could be used as a tool for monitoring and feedback in EM residency training.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87162
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Emergency Medicine
1. 연구논문 > 1. College of Medicine > Yonsei Biomedical Research Center
Yonsei Authors
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Link
 http://kiss.kstudy.com/journal/thesis_name.asp?tname=kiss2002&key=3142409
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