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Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review

BACKGROUND: Referral management centres (RMC) for elective referrals are designed to facilitate the primary to secondary care referral path, by improving quality of referrals and easing pressures on finite secondary care services, without inadvertently compromising patient care. This study aimed to...

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Autores principales: Xiang, Ally, Smith, Helen, Hine, Paul, Mason, Katy, Lanza, Stefania, Cave, Anna, Sergeant, Jonathan, Nicholson, Zoe, Devlin, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3844396/
https://www.ncbi.nlm.nih.gov/pubmed/23945378
http://dx.doi.org/10.1186/1472-6963-13-310
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author Xiang, Ally
Smith, Helen
Hine, Paul
Mason, Katy
Lanza, Stefania
Cave, Anna
Sergeant, Jonathan
Nicholson, Zoe
Devlin, Peter
author_facet Xiang, Ally
Smith, Helen
Hine, Paul
Mason, Katy
Lanza, Stefania
Cave, Anna
Sergeant, Jonathan
Nicholson, Zoe
Devlin, Peter
author_sort Xiang, Ally
collection PubMed
description BACKGROUND: Referral management centres (RMC) for elective referrals are designed to facilitate the primary to secondary care referral path, by improving quality of referrals and easing pressures on finite secondary care services, without inadvertently compromising patient care. This study aimed to evaluate whether the introduction of a RMC which includes triage and feedback improved the quality of elective outpatient referral letters. METHODS: Retrospective, time-series, cross-sectional review involving 47 general practices in one primary care trust (PCT) in South-East England. Comparison of a random sample of referral letters at baseline (n = 301) and after seven months of referral management (n = 280). Letters were assessed for inclusion of four core pieces of information which are used locally to monitor referral quality (blood pressure, body mass index, past medical history, medication history) and against research-based quality criteria for referral letters (provision of clinical information and clarity of reason for referral). RESULTS: Following introduction of the RMC, the proportion of letters containing each of the core items increased compared to baseline. Statistically significant increases in the recording of ‘past medical history’ (from 71% to 84%, p < 0.001) and ‘medication history’ (78% to 87%, p = 0.006) were observed. Forty four percent of letters met the research-based quality criteria at baseline but there was no significant change in quality of referral letters judged on these criteria across the two time periods. CONCLUSION: Introduction of RMC has improved the inclusion of past medical history and medication history in referral letters, but not other measures of quality. In approximately half of letters there remains room for further improvement.
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spelling pubmed-38443962013-12-02 Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review Xiang, Ally Smith, Helen Hine, Paul Mason, Katy Lanza, Stefania Cave, Anna Sergeant, Jonathan Nicholson, Zoe Devlin, Peter BMC Health Serv Res Research Article BACKGROUND: Referral management centres (RMC) for elective referrals are designed to facilitate the primary to secondary care referral path, by improving quality of referrals and easing pressures on finite secondary care services, without inadvertently compromising patient care. This study aimed to evaluate whether the introduction of a RMC which includes triage and feedback improved the quality of elective outpatient referral letters. METHODS: Retrospective, time-series, cross-sectional review involving 47 general practices in one primary care trust (PCT) in South-East England. Comparison of a random sample of referral letters at baseline (n = 301) and after seven months of referral management (n = 280). Letters were assessed for inclusion of four core pieces of information which are used locally to monitor referral quality (blood pressure, body mass index, past medical history, medication history) and against research-based quality criteria for referral letters (provision of clinical information and clarity of reason for referral). RESULTS: Following introduction of the RMC, the proportion of letters containing each of the core items increased compared to baseline. Statistically significant increases in the recording of ‘past medical history’ (from 71% to 84%, p < 0.001) and ‘medication history’ (78% to 87%, p = 0.006) were observed. Forty four percent of letters met the research-based quality criteria at baseline but there was no significant change in quality of referral letters judged on these criteria across the two time periods. CONCLUSION: Introduction of RMC has improved the inclusion of past medical history and medication history in referral letters, but not other measures of quality. In approximately half of letters there remains room for further improvement. BioMed Central 2013-08-14 /pmc/articles/PMC3844396/ /pubmed/23945378 http://dx.doi.org/10.1186/1472-6963-13-310 Text en Copyright © 2013 Xiang et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Xiang, Ally
Smith, Helen
Hine, Paul
Mason, Katy
Lanza, Stefania
Cave, Anna
Sergeant, Jonathan
Nicholson, Zoe
Devlin, Peter
Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
title Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
title_full Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
title_fullStr Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
title_full_unstemmed Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
title_short Impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
title_sort impact of a referral management “gateway” on the quality of referral letters; a retrospective time series cross sectional review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3844396/
https://www.ncbi.nlm.nih.gov/pubmed/23945378
http://dx.doi.org/10.1186/1472-6963-13-310
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