Improving the referral process from primary care to an AMHT

Dehghan, Aaron; Nowar, Maan Abu; Molodynski, Andrew

doi:10.1002/pnp.476

Cited by 6 publications

(8 citation statements)

References 7 publications

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“…There is considerable information on referral from GPs in the primary care sector to secondary care internationally [ 13 , 15 – 19 , 23 ]. Unlike in the current study, these studies [ 18 , 19 , 23 ] showed that the majority of referrals came from GPs. Based on the aforementioned findings that GPs often refer patients according to their symptomatic picture rather than with a confirmed diagnosis [ 17 , 24 , 25 ], we expected that our findings would also comprise of a considerably higher proportion of patients referred from GPs.…”

Section: Discussioncontrasting

confidence: 69%

Today’s referral is tomorrow’s repeat patient: referrals to and between medical outpatient clinics in a hospital

Safi

Clay‐Williams

Thude

et al. 2022

BMC Health Serv Res

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Background Unnecessary referrals in Danish hospitals may be contributing to inefficient use of health services already stretched and under pressure and may lead to delayed treatment for patients. Despite a growing awareness in the literature and in practice of issues related to referrals, there has been relatively little research on referrals between specialists in hospital outpatient clinics and how it can be improved. This study aimed to describe the referral patterns to and within the Medical Department at the University Hospital of Southern Denmark. The Medical Department consists of the following medical specialist outpatient clinics; nephrology, pulmonology, endocrinology, cardiovascular, wound outpatient clinic, and a day hospital. Methods Two specialist physicians assessed all referrals to the medical specialist outpatient clinics over one month (from 01 September 2019 to 30 September 2019) using data drawn from the Danish electronic patient record system (Cosmic). Data on referral pattern, and patient age and sex, were statistically analysed to identify and characterise patterns of referral. Results Four hundred seventy-one (100%) referrals were included in the study. 49.5% (233) of the referrals were from the hospital and 50.5% (238) from general practitioners (GPs). Of the 233 referrals from the hospitals, 31% (72) were from the Medical Department. Conclusion The high rate of referrals (31%) from own Medical Department or outpatient clinics may reflect an inefficient internal referral process within the department. Improved collaboration between specialists could have the potential to improve health outcomes, timely access to care and more appropriate healthcare resource utilisation.

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Section: Discussioncontrasting

confidence: 69%

Today’s referral is tomorrow’s repeat patient: referrals to and between medical outpatient clinics in a hospital

Safi

Clay‐Williams

Thude

et al. 2022

BMC Health Serv Res

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show abstract

“…Another model limitation relates to patient priority. The model assumes first-come first-served, whereas order of service is realistically dependent on priority levels assigned to the referrals [38] .…”

Section: Discussionmentioning

confidence: 99%

Modelling the effect of first-wave COVID-19 on mental health services

Murch

Cooper

Hodgett

et al. 2021

Operations Research for Health Care

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“…The Department of Health estimates that mental health difficulties cost the UK economy between £70bn and £100bn per year (Davies, 2013). With a high prevalence of poor mental health in the UK, mental health services can often be overstretched and insufficiently funded (Dehghan et al , 2017). The associated level of work for practitioners can also mean that services are at risk of acquiring long waiting lists (Marzillier & Hall, 1999).…”

Section: Introductionmentioning

confidence: 99%

“…The associated level of work for practitioners can also mean that services are at risk of acquiring long waiting lists (Marzillier & Hall, 1999). Hence, resource allocation is vital to ensure care is provided in the most appropriate setting and that there are efficient pathways to specialist care for those who need it (Dehghan et al , 2017).…”

Section: Introductionmentioning

confidence: 99%

“…The content and quality of referrals can also vary which can lead to delayed treatment and impact the efficacy of services (Allwood et al , 2019). A lack of necessary information in the referral may affect whether people reach the most appropriate destination first time and the service’s ability to pre-empt appropriateness for therapy prior to assessment (Dehghan et al , 2017). Greater understanding of the referral process by clients and referrers is vital to the clients’ overall health-care experience, with rejected referrals and adjusted timescales a regular cause of client apprehension and uncertainty (Dehghan et al , 2017).…”

Section: Introductionmentioning

confidence: 99%

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A service evaluation of the assessment process in a Step4 Psychological Therapies Service

Robinson

Boos

Moghaddam

2022

MHRJ

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Purpose This study aims to improve the efficiency of the assessment process within a Step4 Psychological Therapies Service by identifying factors related to assessment non-attendance and service suitability for referred clients. Design/methodology/approach Referral and assessment information was accessed between October 2019 and March 2020 from Step4 routine service data, electronic client records where necessary and Step4 staff self-report questionnaires. Findings All clients offered an assessment during this time attended. Findings indicated several factors could influence service suitability in meeting client need. These included individual differences such as readiness to change, which was not necessarily identified at referral or prior to assessment, and potential systemic factors, such as the opt-in procedure, which possibly impeded access. Though the necessity for assessment in clarifying client needs and treatment was indicated, an assessment (from referral to assessment appointment) that led to discharge could take an excess of one working day of service time, associated with considerable opportunity cost to other clients awaiting assessment. Recommendations are made for improving assessment efficiency. Originality/value With a high prevalence of poor mental health in the UK, efforts must be made to identify and reduce additional demand upon service time and resources within mental health services to effectively meet people’s needs. Recommendations to improve assessment process efficiency include the use of a standardised referral form, offer of follow-up support procedures, increased client involvement, a streamlined opt-in battery and ongoing monitoring to ensure shared practice between clinicians. These are transferable to other mental health services, with implications for subsequent quality and timeliness of care.

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Improving the referral process from primary care to an AMHT

Cited by 6 publications

References 7 publications

Today’s referral is tomorrow’s repeat patient: referrals to and between medical outpatient clinics in a hospital

Today’s referral is tomorrow’s repeat patient: referrals to and between medical outpatient clinics in a hospital

Modelling the effect of first-wave COVID-19 on mental health services

A service evaluation of the assessment process in a Step4 Psychological Therapies Service

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