Quality of 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.

Download Full-text

Assessment of the Quality of Glaucoma Referral Letters Based on a Survey of Glaucoma Specialists and a Glaucoma Guideline

Ophthalmology ◽

10.1016/j.ophtha.2013.08.027 ◽

2014 ◽

Vol 121 (1) ◽

pp. 126-133 ◽

Cited By ~ 17

Author(s):

Jason Cheng ◽

Laura Beltran-Agullo ◽

Graham E. Trope ◽

Yvonne M. Buys

Keyword(s):

Referral Letters

Download Full-text

Quality of psychiatric referrals to secondary-level care

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v15i2.207 ◽

2009 ◽

Vol 15 (2) ◽

pp. 4 ◽

Cited By ~ 2

Author(s):

W Struwig ◽

P J Pretorius

Keyword(s):

Quality Criteria ◽

Secondary Level ◽

Conclusive Evidence ◽

Free State ◽

Referral Centre ◽

Provincial Hospital ◽

Physical Examinations ◽

Convenience Sampling ◽

Referral Letters

Objectives. This study examined the quality of referrals to secondary-level outpatient psychiatric services rendered by the Department of Psychiatry, University of the Free State. Referral letters were evaluated according to specific quality criteria. Aspects that would enable secondary-level doctors to make informed decisions in terms of further management and need for special investigations were specifically considered. Design. A descriptive study design was used, and convenience sampling included all referrals to the unit over a 6-month period (June - November 2007). All referral letters were screened according to a checklist designed for this study. Setting. The study was undertaken at the Psychiatry Outpatient Department of the Pelonomi Provincial Hospital in Bloemfontein, which functions as a secondary-level referral centre for mental health in the southern Free State. Outcome measures. Descriptive statistics (percentages, means and standard deviations) were used to summarise results. Results. Two hundred and sixty-three referral letters were included in the study. Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system.Conclusion. There was conclusive evidence that the quality of referrals to the Psychiatry Department was generally inadequate. A need for more effective referral strategies was identified.

Download Full-text

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215113000169 ◽

2013 ◽

Vol 127 (4) ◽

pp. 364-367 ◽

Cited By ~ 6

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.

Download Full-text

An Appraisal of the Quality of Referral Letters from General Dental Practitioners to a Temporomandibular Disorder Clinic

Primary Dental Care ◽

10.1308/135576103322363451 ◽

2003 ◽

Vol os10 (4) ◽

pp. 105-108 ◽

Cited By ~ 4

Author(s):

Annette E O'Donovan ◽

Paul M Ager ◽

Stephen J Davies ◽

Philip W Smith

Keyword(s):

Retrospective Analysis ◽

Temporomandibular Disorders ◽

Temporomandibular Disorder ◽

Insufficient Information ◽

Quality Scale ◽

Dental Practitioners ◽

Dental Hospital ◽

Pro Forma ◽

Referral Letters

Aim To assess the usefulness of referral letters from general dental practitioners (GDPs) to a clinic seeing referrals related to temporomandibular disorders. Design A retrospective analysis of all referral letters received by the TMD clinic at Manchester Dental Hospital over a ten-week period. Methods The new patient referral letters to the TMD clinic were examined against suggested criteria of 16 points of information considered to be useful by clinicians working in the clinic. The letters were then assessed using a quality scale based on the level of useful information given in the letter, and using this scale, classified into groups of ‘very helpful’, ‘some help’ or ‘a little helpful’. Results Out of the 100 letters analysed, the majority (94) proved to be a ‘little helpful’ for the TMD clinician; that is to say, the letter included only 0–4 points (out of 16) regarded as important information for the specialist. The maximum number of points of information contained in a letter was nine. No letters were categorised as ‘very helpful’ for the clinician, and only 6% of the referral letters were considered to provide some help (5–12 points). Conclusions During the period of the study, in general, referral letters to the TMD clinic concerned contained insufficient information. The introduction of a referral pro forma, produced by the TMD clinic, and guidelines might improve the quality of referrals.

Download Full-text

Quality of Written Reports Provided by Consultants in Restorative Dentistry to Referring General Dental Practitioners in the West Midlands

Primary Dental Care ◽

10.1308/135576106776337841 ◽

2006 ◽

Vol os13 (2) ◽

pp. 63-69 ◽

Cited By ~ 3

Author(s):

Shuva Saha ◽

Anthony J Summerwill

Keyword(s):

Postal Questionnaire ◽

Primary Objective ◽

The West ◽

Standard Format ◽

Dental Practitioners ◽

West Midlands ◽

Dental Hospital ◽

Bullet Point ◽

Referral Letters

Objectives The primary objective of this study was to assess the views of general dental practitioners (GDPs) on the content, style, and readability of written reports provided by restorative consultants at a dental hospital in response to referral letters from the GDPs. The secondary objective was to determine the style of the written consultant report preferred by GDPs. Setting Referral letters received and replied to by four consultants in the restorative department at Birmingham Dental Hospital. Method The quality of written reports sent by the four consultants to 100 referring GDPs in the West Midlands area was evaluated using a postal questionnaire, which assessed 100 GDPs’ satisfaction with the content, style, and readability of the reports. To assess which format they favoured a second questionnaire was subsequently sent to the same GDPs with three versions of the original report in: (a) a standard format, (b) a summary format, and (c) a bullet point format. Results The results of the initial questionnaire revealed that 79 (96%) of practitioners were satisfied with the existing style of the reports. Following a second questionnaire in which GDPs were asked to choose which format they preferred, 61 (81%) expressed a preference for a bullet point or summary style report. Conclusion The GDPs who responded to the questionnaires felt that a bullet point format or summary style report from the consultants concerned would summarise cases more clearly and concisely than the conventional standard format letters which they had previously received. Opportunities may exist for improving the quality of consultant reply letters through the use of structured templates and/or a summary or bullet point format.

Download Full-text

Improving osteoarthritis management in primary healthcare: results from a quasi-experimental study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03959-6 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Nina Østerås ◽

Irma Brandeggen Blaker ◽

Tore Hjortland ◽

Elizabeth Cottrell ◽

Jonathan G. Quicke ◽

...

Keyword(s):

Quality Of Care ◽

Weight Control ◽

Best Practice ◽

Interrupted Time Series ◽

Treatment Modalities ◽

Implementation Phase ◽

Logistic Regression Models ◽

Patient Reported ◽

Referral Letters

Abstract Background To improve quality of care for patients with hip and knee osteoarthritis (OA), general practitioners (GPs) and physiotherapists (PTs) in a Norwegian municipality initiated an intervention. The intervention aimed to increase provision of core OA treatment (information, exercise, and weight control) prior to referral for surgery, rational use of imaging for assessing OA and improve communication between healthcare professionals. This study assessed the effectiveness of this intervention. Methods Forty-eight PTs and one hundred one GPs were invited to the intervention that included two interactive workshops outlining best practice and an accompanying template for PT discharge reports. Using interrupted time series research design, the study period was divided into three: pre-implementation, transition (implementation) and post-implementation. Comparing the change between pre- and post-implementation, the primary outcome was patient-reported quality of OA care measured with the OsteoArthritis Quality Indicator questionnaire. Secondary outcomes were number of PT discharge reports, information included in GP referral letters to orthopaedic surgeon, the proportion of GP referral letters indicating use of core treatment, and the use of imaging within OA assessment. Analyses involved linear mixed and logistic regression models. Results The PT workshop had 30 attendees, and 31 PTs and 33 GPs attended the multidisciplinary workshop. Two hundred eight and one hundred twenty-five patients completed the questionnaire during pre- and post-implementation, respectively. The adjusted model showed a small, statistically non-significant, increase in mean total score for quality of OA care (mean change = 4.96, 95% CI -0.18, 10.12, p:0.057), which was mainly related to items on OA core treatment. Patients had higher odds of reporting receipt of information on treatment alternatives (odds ratio (OR) 1.9, 95% CI 1.08, 3.24) and on self-management (OR 2.4, 95% CI 1.33, 4.32) in the post-implementation phase. There was a small, statistically non-significant, increase in the proportion of GP referral letters indicating prior use of core treatment modalities. There were negligible changes in the number of PT discharge reports, in the information included in the GP referral letters, and in the use of imaging for OA assessment. Conclusion This study suggests that a primary care intervention including two inter-active workshops can shift the quality of care towards best practice recommendations. Trial registration ClinicalTrials.gov: NCT02876120.

Download Full-text

AB1473-HPR Quality of referral letters received in rheumatology

10.1136/annrheumdis-2018-eular.5275 ◽

2018 ◽

Author(s):

D Palma-Sanchez ◽

A.D.C. Haro-Martinez ◽

M.J. Moreno-Martinez ◽

E. Peñas-Gonzalez

Keyword(s):

Referral Letters

Download Full-text