“Consultas de pasillo” (curbside consultation): otra actividad asistencial del infectólogo / Curbside consultation: Another healthcare activity of the infectious disease specialist

Introducción Se define “consulta de pasillo” (CP) como el proceso informal en el que un médico obtiene información de otro médico en el tratamiento de un paciente que nunca ha valorado el médico consultado. Material y métodos Estudio prospectivo observacional que tiene como objetivo conocer la frecuencia, los contenidos, los servicios demandantes y el resultado final de las CP realizadas a la Unidad de Enfermedades Infecciosas (UEI) en el período del 25-03-2008 al 5-12-2008. Las variables recogidas eran relativas al medio de contacto, tipo de pregunta, persona solicitante, complejidad del tema, tema relativo, recomendaciones y grado de seguimiento y evolución de la consulta. El grado de dificultad se evaluó mediante el sistema de la ACP (American Collage of Physicians). Se emplearon métodos estadísticos paramétricos y no paramétricos. ResultadosSe recabaron 208 CP (1,13/día), con una mediana de 2min. Los motivos de consulta más frecuentes fueron seleccionar un antimicrobiano (54,4%), evaluar el diagnóstico (10,5%), interpretación de datos microbiológicos (9,6%) y la combinación de varios motivos (27,4%). En el 5,8% se precisó ingreso para estudio y tratamiento de la enfermedad infecciosa. Se requirió una interconsulta formal en el 27% de los casos. Se encontraron diferencias significativas entre médicos adjuntos y residentes y las realizadas por servicios médicos y quirúrgicos. Conclusiones Queremos destacar que las CP suponen una parte importante de la actividad asistencial de la UEI, aunque en su mayoría son sencillas y no suponen una carga de trabajo excesiva. Sin embargo, cuando se trata de consultas de caso clínico, realizadas por staff, con un grado de dificultad alto y que implican servicios quirúrgicos generan una actividad formal significativa (AU)

Introduction “Curbside consultation” is the term used to describe an informal process in which a physician requests information from another physician about the management of a patient who has not been assessed by the person consulted. Material and Methods Prospective, observational study designed to determine the frequency, services requested, and final result of curbside consultations made over the period of 3 March to 12 May 2008. The variables recorded included the means by which contact was made, the type of question, person requesting information, complexity of the subject, related subject, recommendations, and degree of follow-up and evolution of the consultation. The degree of difficulty was evaluated using the system of the American Collage of Physicians. Parametric and nonparametric statistical tests were used in the analysis. Results A total of 208 consultations (1.13/day) were reported, lasting a median of 2 minutes. The most common reasons for consulting were selection of an antimicrobial agent (54.4%), evaluation of a diagnosis (10.5%), interpretation of microbiological data (9.6%), and a combination of reasons (27.4%). In 5.8% of cases, hospitalization was required to study and treat the infectious disease. A formal consultation was required in 27% of cases. Significant differences were found between staff physicians and medical residents and between medical and surgical departments. Conclusions Curbside consultations comprise an important part of healthcare activity in the Infectious Disease Department, although most requests are easily resolved and do not imply an excessive work burden. Nonetheless, when the consultation involves a difficult clinical case, the request is by a staff physician, and the surgery department is implicated, a significant amount of formal activity is generated (AU)

[Curbside consultation: another healthcare activity of the infectious disease specialist]. / "Consultas de pasillo" (curbside consultation): otra actividad asistencial del infectólogo.

INTRODUCTION: "Curbside consultation" is the term used to describe an informal process in which a physician requests information from another physician about the management of a patient who has not been assessed by the person consulted. MATERIAL AND METHODS: Prospective, observational study designed to determine the frequency, services requested, and final result of curbside consultations made over the period of 3 March to 12 May 2008. The variables recorded included the means by which contact was made, the type of question, person requesting information, complexity of the subject, related subject, recommendations, and degree of follow-up and evolution of the consultation. The degree of difficulty was evaluated using the system of the American Collage of Physicians. Parametric and nonparametric statistical tests were used in the analysis. RESULTS: A total of 208 consultations (1.13/day) were reported, lasting a median of 2 minutes. The most common reasons for consulting were selection of an antimicrobial agent (54.4%), evaluation of a diagnosis (10.5%), interpretation of microbiological data (9.6%), and a combination of reasons (27.4%). In 5.8% of cases, hospitalization was required to study and treat the infectious disease. A formal consultation was required in 27% of cases. Significant differences were found between staff physicians and medical residents and between medical and surgical departments. CONCLUSIONS: Curbside consultations comprise an important part of healthcare activity in the Infectious Disease Department, although most requests are easily resolved and do not imply an excessive work burden. Nonetheless, when the consultation involves a difficult clinical case, the request is by a staff physician, and the surgery department is implicated, a significant amount of formal activity is generated.