The GP—hospital interface: attitudes of general practitioners to tertiary teaching hospitals

Abstract

ObjectiveTo assess general practitioner (GP) perceptions of liaison with two local tertiary teaching hospitals. DesignQuestionnaire‐based survey of GP attitudes. SettingMelbourne and North West Melbourne Divisions of General Practice, in July and September 1994. ParticipantsAll GPs (587) practising in the Divisions (identified from Health Insurance Commission lists of consultations charged at GP rates). Outcome MeasuresDegree of agreement on a 5‐point Likert scale to statements about GP—hospital liaison, and relevant open comments. Results350 GPs (60%) responded, including 84% of vocationally registered GPs; 68% of the 350 were in full‐time practice and 70% had been in practice for over 10 years. GPs had no clear strategy for obtaining admission of semi‐urgent patients to public hospitals. For patients needing urgent admission, almost a third of GPs sometimes resorted to sending them to the emergency department without first telephoning. Most GPs agreed that hospitals did not notify them of patient admission (84%), major changes in patient condition, including death (87%), and patient discharge (75%). Most would interrupt a consultation to discuss a patient with hospital staff (92%). About half agreed they had poor access to outstanding results, and 65% were concerned that proposed early‐discharge practices would be detrimental to patient care. ConclusionsThe survey identified considerable GP dissatisfaction with hospital—GP communication and GP willingness to be more involved in liaison and communication with hospitals about patient care. Changes in hospital organisation and hospital staff attitudes are needed to allow this.

Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

“…[21][22][23][24][25] Furthermore, shorter periods of hospitalization, coupled with increasing warfarin usage, are placing additional stresses on the community-based services caring for anticoagulated patients' post-discharge. [26][27][28] Waiting times between acute in-hospital treatment and admission to rehabilitation clinics, as well as abstention from stationary rehabilitation programs, form objective adherence barriers. [29] To overcome and to manage experiences with anticoagulation complications, many of the studies have reported the role of out-patient anticoagulation clinics, such as improving outcomes through patient engagement, improved health literacy and improved medication adherence.…”

Omission of Dysphagia Therapies in Hospital Discharge Communications

“…Although hospitals often utilize additional discharge paperwork, these other documents are institution-specific, not required, and not always present [27, 32-35]. Direct verbal communication between care settings is rare [27].…”

General practitioner–hospital communications: A review of discharge summaries

“…Historically the discharge summary has been found to be poorly written, 1,2 contain inaccurate 3–5 or ineffective 6 information, and received too late 7,8 to be of any significant value. A number of areas, identified by previous studies, have been found lacking when looking at the quality of the discharge summary.…”