Impact of referral letters on scheduling of hospital appointments: a randomised control trial

Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Pillai, Vinita

doi:10.3399/bjgp14x680509

Cited by 9 publications

(24 citation statements)

References 18 publications

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“…First, there is possible bias whereby more proactive GPs may be inclined to use the referral templates and thereby skew results. Second, adherence to the referral template may be variable depending on workload and time constraints Jiwa et al (2014) Australia, 102 GPs Quantitative study using single-blind, parallel-groups, controlled design with a 1:1 randomisation used to evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters This paper took into account that there was no doctor-patient interaction as actors are used to play the role of the patient. In phase one, GPs were shown vignettes of an actor-patient performing a monologue and phase two, the intervention group used the referral software and the control group did not.…”

Section: Review Of Referrals By Triaging Gps Who Gave Feedback To Refmentioning

confidence: 99%

“…Evans (2009) 4 Improvement in referral quality and reducing inappropriate demand Xiang et al (2013) 3 Improvement in referral quality and decisions made will be more accurate Elwyn et al (2007) 3 Improving the quality of referrals and reducing demand Templates Haley et al (2015) 3 Improvement in documentation Rokstad et al (2013) 4 Improvement in referral quality and in time efficiency by the specialist reviewing the letters Wahlberg et al (2015) 3 Improvement in documentation Wahlberg et al (2016) 3 Sought to prove association with patient experience compared with control but none seen Wahlberg et al (2017) 3 Sought to prove association with improved quality of care through quality indicators but none seen Eskeland et al (2017) 3 Improvement in referral quality Jiwa et al (2014) 3 Improvement in documentation of clinically relevant data. Referral times unchanged.…”

Section: Peer Feedbackmentioning

confidence: 99%

See 1 more Smart Citation

Improving quality of referral letters from primary to secondary care: a literature review and discussion paper

Tobin-Schnittger

O’Doherty

O’Connor

et al. 2017

Prim Health Care Res Dev

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Section: Review Of Referrals By Triaging Gps Who Gave Feedback To Refmentioning

confidence: 99%

Section: Peer Feedbackmentioning

confidence: 99%

Improving quality of referral letters from primary to secondary care: a literature review and discussion paper

Tobin-Schnittger

O’Doherty

O’Connor

et al. 2017

Prim Health Care Res Dev

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“…Second, as the cases were all standardised actor-patients, the GPs were not required to recruit patients and obtain informed consent, therefore data were obtained for all cases. Such advantages have facilitated research with similar challenging scenarios in the past 26. Three limitations also warrant mention.…”

Section: Discussionmentioning

confidence: 99%

Management of behavioural change in patients presenting with a diagnosis of dementia: a video vignette study with Australian general practitioners

et al. 2014

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ObjectiveTo test the impact of feedback on the proposed management of standardised patients presenting with behavioural change with a diagnosis of dementia in Australian primary care.Materials and methodsA video vignette study was performed with Australian general practitioners (GPs) in 2013. Participants viewed six pairs of matched videos depicting people presenting changed behaviour in the context of a dementia diagnosis in two phases. In both phases GPs indicated their diagnosis and management. After phase 1, GPs were offered feedback on management strategies for the patients depicted. Analyses focused on identification of change in management between the two phases of the study. Factors impacting on the intention to coordinate care for such patients were tested in a questionnaire based on the Theory of Planned Behaviour.ResultsForty-five GPs completed the study. There was significant improvement in the proposed management of three of the six scenarios after the intervention. Older GPs were more likely to refer appropriately (OR=1.11 (1.01 to 1.23), p=0.04.). Overall referral to support agencies was more likely after the intervention (OR=2.52 (1.53 to 4.14), p<0.001). Older GPs were less likely to intend to coordinate care for such patients (OR=0.89 (0.81 to 0.98) p=0.02). Participants who felt confident about their ability to coordinate care were more likely to do so (OR=3.79 (1.08 to 13.32) p=0.04).ConclusionsThe intervention described in this study promoted multidisciplinary management of patients with behavioural problems with a diagnosis of dementia. Increasing practitioner confidence in their ability to coordinate care may increase the proportion of GPs who will respond to patients and carers in this context. Older GPs may benefit in particular.

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“…Also, although the 2 randomized trials included in the present review, both of which evaluated software-based interventions, improved the amount of information within a referral request, each failed to meet its goal of increasing consultation of guidelines 31 and improving specialist confidence in scheduling of appointments. 29 Thus, although the research team concluded that both succeeded in improving the primary outcome of this review (improving the content of referral requests), both studies concluded that their interventions were unsuccessful.…”

Section: Context Of Other Evidencementioning

confidence: 95%

Interventions to Improve the Quality of Outpatient Specialty Referral Requests

et al. 2016

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Requests for outpatient specialty consultations occur frequently but often are of poor quality because of incompleteness. The authors searched bibliographic databases, trial registries, and references during October 2014 for studies evaluating interventions to improve the quality of outpatient specialty referral requests compared to usual practice. Two reviewers independently extracted data and assessed quality. Findings were qualitatively summarized for completeness of information relayed in a referral request within naturally emerging intervention categories. Of 3495 articles screened, 11 were eligible. All 3 studies evaluating software-based interventions found statistically significant improvements. Among 4 studies evaluating template/pro forma interventions, completeness was uniformly improved but with variable or unreported statistical significance. Of 4 studies evaluating educational interventions, 2 favored the intervention and 2 found no difference. One study evaluating referral management was negative. Current evidence for improving referral request quality is strongest for software-based interventions and templates, although methodological quality varied and findings may be setting specific.

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Impact of referral letters on scheduling of hospital appointments: a randomised control trial

Cited by 9 publications

References 18 publications

Improving quality of referral letters from primary to secondary care: a literature review and discussion paper

Improving quality of referral letters from primary to secondary care: a literature review and discussion paper

Management of behavioural change in patients presenting with a diagnosis of dementia: a video vignette study with Australian general practitioners

Interventions to Improve the Quality of Outpatient Specialty Referral Requests

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