scholarly journals Quality of GPs' referral letters to diabetes secondary care

2003 ◽  
Vol 20 (5) ◽  
pp. 165-169 ◽  
Author(s):  
AA Syed ◽  
DM Large
Keyword(s):  
Secondary Care ◽  
Referral Letters

Do rhinology care pathways in primary care influence the quality of referrals to secondary care?

2013 ◽  
Vol 127 (4) ◽  
pp. 364-367 ◽  
Author(s):  
N Su ◽  
P P Cheang ◽  
H Khalil
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Secondary Care ◽  
Evidence Based ◽  
Care Pathways ◽  
Diagnosis And Management ◽  
Care Guidelines ◽  
Evidence Based Guidelines ◽  
Referral Letters

AbstractBackground:Chronic sinusitis is the most common routine presentation for a general ENT surgeon. The 2007 ‘Primary Care Guidelines: European Position Paper on the Primary Care Diagnosis and Management of Rhinosinusitis and Nasal Polyps’ aimed to deliver evidence-based guidelines for the diagnosis and management of rhinosinusitis in specialist and primary care.Objective:The aim of this audit was to assess the information provided in the referral letters to the ENT department regarding patients with potential rhinosinusitis, and compare this to the information required for the rhinology care pathways.Method:We evaluated one month of referrals to the ENT department.Results:The quality of information in the referral letters was poor. Only 22 per cent of patient referrals included basic information about symptoms, duration and treatment.Conclusion:We plan to investigate why general practitioners are not complying with the pathway. In addition, the pathways will be more widely disseminated via the ‘Map of Medicine’ (an online resource for general practitioners). This should facilitate the receipt of the best evidence-based treatment for patients prior to referral to secondary care.

scholarly journals The effects of audit and feedback and electronic referrals on the quality of primary care referral letters

2014 ◽  
Vol 6 (4) ◽  
pp. 324 ◽  
Author(s):  
Paul Corwin ◽  
Tim Bolter
Keyword(s):  
Primary Care ◽  
General Practice ◽  
General Practitioners ◽  
West Coast ◽  
Secondary Care ◽  
Referral Letter ◽  
The West ◽  
Electronic Referral ◽  
Referral Letters

INTRODUCTION: Appropriate referral from primary care to hospital specialists is a critical component of general practice patient management. This study investigated the quality of such referrals in a group of general practitioners (GPs) and nurses. AIM: To assess whether feedback improves the quality of referral letters from general practice to secondary care and how electronic referrals affect the quality of referral letters. METHODS: All 15 GPs working on the West Coast in New Zealand and the two nurses in this locality who regularly wrote referral letters agreed to participate in the study. For each participant, referral letters to hospital specialists were assessed using a nine-point checklist. Ten consecutive letters were assessed for each participant. Written feedback on referral letter quality was given and a further 10 letters from each participant were assessed five months later. After a further five months, 10 electronic referral letters from each participant were assessed. RESULTS: Feedback to general practitioners and nurses improved the quality of referral letters for participants whose original referral letters were of poorer quality. The average score for referral letters was 81.4% at baseline and this improved to 86.9% after feedback. The introduction of electronic referral letters did not lead to a further improvement in referral letter quality. DISCUSSION: This study demonstrated that feedback to general practitioners and nurses can improve the quality of referral letters to secondary care. The introduction of electronic referral letters as used on the West Coast did not lead to any further improvement in referral quality. KEYWORDS: Hospital referrals; primary health care; quality improvement

scholarly journals Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035837 ◽  
Author(s):  
Chantal Edge ◽  
Julie George ◽  
Georgia Black ◽  
Michelle Gallagher ◽  
Aftab Ala ◽  
...  
Keyword(s):  
Focus Groups ◽  
Secondary Care ◽  
Normalisation Process Theory ◽  
Effectiveness Study ◽  
Female Prisoners ◽  
Implementation Effectiveness ◽  
Hybrid Type ◽  
Access Cost

IntroductionPeople in prison tend to experience poorer health, access to healthcare services and health outcomes than the general population. Use of video consultations (telemedicine) has been proven effective at improving the access, cost and quality of secondary care for prisoners in the USA and Australia. Implementation and use in English prison settings has been limited to date despite political drivers for change. We plan to research the implementation of a new prison-hospital telemedicine model in an English county to understand what factors drive or hinder implementation and whether the model can improve healthcare outcomes as demonstrated in other contextual settings.Methods and analysisWe will undertake a hybrid type 2 implementation effectiveness study to gather evidence on both clinical and implementation outcomes. Data collection will be guided by the theoretical constructs of Normalisation Process Theory. We will prospectively collect data through: (1) prisoner/patient focus groups, interviews and questionnaires, (2) prison healthcare, hospital and wider prison staff interviews and questionnaires, (3) routine quality improvement and service evaluation data. Up to four prisons and three hospital settings in Surrey (England) will be included in the telemedicine research, dependent on their telemedicine readiness during the study period. Prisons proposed include male and female prisoners, remand (not yet sentenced) and sentenced individuals and different security categorisations. In addition, focus groups in five telemedicine naïve prisons will provide information on patient preconceptions and concerns surrounding telemedicine.Ethics and disseminationThis study has received National Health Service Research Ethics Committee, Her Majesty’s Prison and Probation Service National Research Committee and Health Research Authority approval. Dissemination of results will take place through peer-reviewed journals, conferences and existing health and justice networks.

scholarly journals Accessibility and quality of secondary care rheumatology services for people with inflammatory arthritis: a regional survey

2007 ◽  
Vol 7 (6) ◽  
pp. 579-584 ◽  
Author(s):  
RS Sandhu ◽  
GJ Treharne ◽  
EA Justice ◽  
AC Jordan ◽  
S Saravana ◽  
...  
Keyword(s):  
Secondary Care ◽  
Inflammatory Arthritis ◽  
Regional Survey

scholarly journals Effectiveness of inhaled corticosteroids in real life on clinical outcomes, sputum cells and systemic inflammation in asthmatics: a retrospective cohort study in a secondary care centre

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018186 ◽  
Author(s):  
Sophie F Demarche ◽  
Florence N Schleich ◽  
Monique A Henket ◽  
Virginie A Paulus ◽  
Thierry J Van Hees ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Outcomes ◽  
Asthma Control ◽  
Secondary Care ◽  
Inhaled Corticosteroids ◽  
Real Life ◽  
Care Centre ◽  
Eosinophilic Inflammation ◽  
Sputum Eosinophils

ObjectivesThe impact of inhaled corticosteroids (ICS) on eosinophilic inflammation in asthma is well established, but their effect in a real-life setting has not been extensively studied. Our purpose was to investigate the effect of ICS on airway and systemic inflammation as well as on clinical outcomes in patients with asthma from clinical practice.Design, setting and participantsWe conducted a retrospective analysis on asthmatics from a secondary care centre in whom ICS were initiated/increased (n=101), stopped/decreased (n=60) or remained stable (n=63, used as a control group) between two visits with available sputum and blood cell counts.ResultsThe median time between both visits ranged from 1 to 2 years. Initiating or increasing ICS (median variation (IQR): 800 (400–1200) µg beclomethasone equivalent dose per day) reduced sputum eosinophils and fractional exhaled nitric oxide (P<0.0001) and to a lesser extent blood eosinophils (P<0.0001), while withdrawing or decreasing ICS (median variation (IQR): 900 (500–1200) µg beclomethasone equivalentdose per day) resulted in increased sputum eosinophils (P=0.008). No change was found in patients with a stable dose. The effectiveness of ICS in improving asthma control, quality of life, forced expiratory volume in 1 s (FEV1), bronchial hyper-responsiveness and exacerbation rate was only observed in the eosinophilic phenotype (sputum eosinophils ≥3%, n=79). In non-eosinophilic asthmatics, stepping-down ICS resulted in an improvement in asthma control and quality of life, without any significant change in FEV1(n=38).ConclusionsOur results confirm the effectiveness of ICS on eosinophilic inflammation in real life and demonstrate that their clinical benefit seems to be restricted to eosinophilic asthmatics. Our data also support a try for stepping-down ICS in non-eosinophilic asthmatics.

scholarly journals The Referral System between Primary and Secondary Health Care in Saudi Arabia for Patients with Type 2 Diabetes: A Systematic Review

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Mohammed Senitan ◽  
Ali Hassan Alhaiti ◽  
James Gillespie ◽  
Badar Faiz Alotaibi ◽  
George Binh Lenon
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Saudi Arabia ◽  
Systematic Approach ◽  
Referral System ◽  
Secondary Health Care ◽  
Referral Systems ◽  
Referral Letters

Background. In Saudi Arabia, the mortality of diabetes is currently reported at 6%. A well-administered referral system is crucial in aiding the management of this disease. Method. A single reviewer employed a systematic approach to searching the literature databases with regard to the question: what are the attributes of referral systems in Saudi Arabia for patients with type 2 diabetes (T2D)? The results were analysed in order to provide recommendations to improve the Saudi health system. Results. Twelve primary studies were identified from a systematic search. Overall, the 12 studies did not clearly mention any of the factors of a good referral system. The referral problems identified by this study included patients’ unnecessary requests for referral, unstructured referral letters, and unclear dissemination guidelines for referral. Conclusions. This research attempted to identify the efficiency of the referral processes that were implemented for patients with T2D. The majority of the included studies were completely silent on the main referral factors for patients. If this review is representative of the referral system in Saudi Arabia, then, in the context of T2D, current referrals are unsafe. Further research on the quality of the referral system, taking into account at least some of the WHO referral guidelines, is required.

Quality of referral letters

BDJ ◽  
2004 ◽  
Vol 197 (2) ◽  
pp. 82-82
Author(s):  
B Robinson
Keyword(s):  
Referral Letters
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