Referral letters: are we prioritizing consistently?

2005 ◽  
Vol 119 (5) ◽  
pp. 377-380 ◽  
Author(s):  
David D Pothier ◽  
Costa Repanos
Keyword(s):  
General Practice ◽  
Waiting Time ◽  
Fast Track ◽  
Evidence Based ◽  
Rater Reliability ◽  
Significant Difference ◽  
Prospective Assessment ◽  
The Mean ◽  
Evidence Based Guidelines ◽  
Referral Letters

Objectives: To determine the levels of intra- and inter-grade variability of the vetting of general practice (GP) letters as well as the intra-rater reliability of letterprioritization.Design: Prospective assessment of letter vetting and questionnaire survey.Setting: Three otolaryngology secondary referral centres in Bristol and Bath, UK.Participants: Twelve consultants, nine registrars, four staff and associate specialists (SAS) and 16 senior house officers (SHOs) in otolaryngology.Methods: Fifty GP letters (not including ’fast-track’ referrals) addressed to one of the ENT departments were chosen sequentially. These were anonymized, photocopied and included in the questionnaire to all participating staff. Participants were asked to vet the letters as ’urgent’, ’soon’ or ’routine’ according to supplied waiting time criteria. The same letters were sent out again six weeks later.Results: There was no significant difference between grades for the mean number of letters vetted into each category. Intra-grade variability was high; the number of letters vetted urgentvaried from one out of 50 to 15 out of 50 for the consultants.The intra-rater reliability was high.Conclusion: The grade of trainee seems to make little difference with regard to ability to prioritize referrals, but within grades there is little agreement on what constitutes an urgent referral. We suggest further research, looking at the final outcome of patients, needs to be done to try to establish evidence-based guidelines to assist with letter vetting.

scholarly journals Guidelines for assessing postnatal problems: introducing evidence-based guidelines in Australian general practice

2003 ◽  
Vol 20 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Jane Gunn ◽  
Donna Southern ◽  
Patty Chondros ◽  
Philippa Thomson ◽  
Kathryn Robertson
Keyword(s):  
General Practice ◽  
Evidence Based ◽  
Australian General Practice ◽  
Evidence Based Guidelines

scholarly journals Assessment of Knowledge and Compliance to Evidence-Based Guidelines for VAP Prevention among ICU Nurses in Tanzania

2020 ◽  
Author(s):  
Vicent Bankanie ◽  
Anne Outwater ◽  
Li Wang ◽  
Li Yinglan
Keyword(s):  
Nursing Education ◽  
Knowledge Score ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Local Context ◽  
Evidence Based ◽  
Cross Sectional ◽  
Effective Measure ◽  
The Mean ◽  
Evidence Based Guidelines

Abstract Background: Implementation of evidence-based guidelines (EBGs) related to VAP is an effective measure for the prevention of ventilator-associated pneumonia (VAP). While low knowledge regarding the EBGs related to VAP prevention among ICU nurses is still a major concern among nurses in ICUs globally, the situation in Tanzania is scarcely known. This study aimed to assess the ICU nurses’ knowledge, compliance, and barriers toward evidence-based guidelines for the prevention of VAP in Tanzania.Methods: A cross-sectional study, involving ICU nurses of major hospitals in Tanzania, was conducted. A structured questionnaire was administered among 116 ICU. Data analysis included descriptive statistics and independent t-test.Results: The mean knowledge score was 38.6% which is lower than the lowest ever reported knowledge score for EBGs for VAP prevention. Nurses with a degree or higher level of nursing education performed significantly better than the nurses with a diploma or lower level of nursing education(p=0.004). The mean self-reported adherence score for EBGs for the prevention of VAP was 60.8%. The main barriers to the implementation of EBGs for VAP prevention were lack of skills (96.6%), lack of adequate staff (95.5%), and lack of knowledge (79.3%).Conclusion: Considering the severity and impact of VAP, and the higher risks of HAIs in resource-limited countries like Tanzania, the lower level of knowledge and compliance implies the need for on-going educational interventions and evaluation of the implementation of the EBGs for VAP prevention by considering the local context.

Treatment of hypertension in Finnish general practice seems unsatisfactory despite evidence‐based guidelines

2009 ◽  
Vol 18 (1-2) ◽  
pp. 62-67 ◽  
Author(s):  
Juha Varis ◽  
Heljä Savola ◽  
Risto Vesalainen ◽  
Ilkka Kantola
Keyword(s):  
General Practice ◽  
Evidence Based ◽  
Treatment Of Hypertension ◽  
Evidence Based Guidelines

scholarly journals Audit of availability and awareness of guidelines for the management of confusion in older patients on general wards

2008 ◽  
Vol 32 (4) ◽  
pp. 143-145
Author(s):  
Ceri G. Evans ◽  
Charles d'Souza ◽  
Paul Reynolds ◽  
Caroline Linton ◽  
Lokesh Nukalapati ◽  
...  
Keyword(s):  
Action Plan ◽  
Minimal Change ◽  
Clinical Implications ◽  
Junior Doctors ◽  
Evidence Based ◽  
Action Plans ◽  
Older Patient ◽  
Significant Difference ◽  
General Wards ◽  
Evidence Based Guidelines

Aims and MethodConfusion in an older patient on a general hospital ward requires prompt and appropriate management. To this end, evidence-based guidelines have been produced and disseminated by Gwent Healthcare NHS Trust. An audit was carried out when it became apparent that junior doctors might not be aware of the guidelines and that their availability on the wards was limited. An action plan was generated and a second audit carried out. Our aim was to establish whether the doctors' knowledge of the guidelines and their availability on wards changed as a result of our action plan and audit.ResultsThe audit consisted of a survey of general wards at the Royal Gwent Hospital and at St Woolos Hospital to assess availability of the guidelines and a questionnaire administered to a sample of junior doctors. The guidelines were available on 17% of wards; 11% of junior doctors were aware of them. Results of the audit informed implementation of an action plan. The second audit showed a limited improvement in availability (increased to 34%) and awareness (increased to 15%) of the guidelines, with no statistically significant difference.Clinical ImplicationsApparently well-thought-out action plans may produce minimal change, but unless the audit cycle is completed this fact cannot be corroborated. In generating action plans, more consideration may need to be given to the factors that influence the spread of change in healthcare systems.

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 Comparison of Visit Length and Waiting Time of Patients in Public and Private Clinics in the North of Iran

Health Scope ◽  
2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Raana Gholamzadeh Nikjoo ◽  
Mobin Sokhanvar ◽  
Khadijeh Motahari ◽  
Yegane Partovi ◽  
Mohammad Taghi Khodayari
Keyword(s):  
Waiting Time ◽  
Random Sampling ◽  
Simple Random Sampling ◽  
Public And Private ◽  
Patients Satisfaction ◽  
The North ◽  
Mean Waiting Time ◽  
Significant Difference ◽  
North Of Iran ◽  
The Mean

Background: The visit length is considered one of the indicators for assessing patients’ satisfaction. Factors such as waiting time for getting a visit affects the desirability of the visit. Objectives: This study aimed to investigate the visit length and waiting time of patients in public and private clinics in Tabriz. Methods: This is a descriptive-analytic study conducted in five clinics in 2018. A questionnaire-based survey was used to collect data from 386 participants recruited through simple random sampling. Mann-Whitney U and Kruskal-Wallis tests were applied to analyze the data using SPSS version 22.0. Results: Overall, the mean visit length was 25.5 and 25.4 min in public and private centers, respectively, while the mean waiting time was 141.2 and 156.4 min in public and private centers, respectively. There was no significant difference between public and private centers regarding the visit length (P > 0.05); however, there was a significant difference between public and private centers in terms of waiting time (P < 0.05). Conclusions: The waiting time was too much, especially in private clinics, which can negatively affect patient satisfaction. Therefore, suggested interventions may consist of using internet and telephone admission, scheduling a waiting list, and requiring physicians to be present on time.

scholarly journals Experiences of telehealth in general practice in Australia: research protocol for a mixed methods study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0187
Author(s):  
Sarah J White ◽  
Amy Nguyen ◽  
Peter Roger ◽  
Tim Tse ◽  
John A Cartmill ◽  
...  
Keyword(s):  
General Practice ◽  
Conversation Analysis ◽  
General Practitioners ◽  
Direct Evidence ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Practice Setting ◽  
Australian General Practice ◽  
Evidence Based Guidelines ◽  
The Impact

BackgroundDue to the COVID-19 pandemic, use of telehealth has expanded rapidly. However, little is known about the impact of delivering care through telehealth on communication between clinicians and patients. At an interactional level, the ways in which clinicians establish rapport and connection with their patients in telehealth consultations is not well understood.AimThis study will explore interactional practices of general practitioners (GPs) and patients in telehealth consultations to develop evidence-based resources to improve communication.Design & settingThe study will be conducted within the Australian general practice setting.MethodConversation analysis and sociolinguistic discourse analysis of recorded telehealth consultations will provide direct evidence of specific elements contributing to successful and less successful instances of telehealth communication. This analysis will be complemented by co-design techniques such as qualitative and reflective interviews and collaborative workshops with telehealth users, including both general practitioners and patients.ConclusionEffective communication is critical for telehealth consultations and is central to achieving optimal clinical outcomes and patient satisfaction. This study will co-develop with end-users, evidence-based guidelines encompassing effective telehealth communication strategies.

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