TY - JOUR
T1 - Improving quality of referral letters from primary to secondary care
T2 - A literature review and discussion paper
AU - Tobin-Schnittger, Patrick
AU - O'Doherty, Jane
AU - O'Connor, Ray
AU - O'Regan, Andrew
N1 - Publisher Copyright:
© 2017 Cambridge University Press.
PY - 2018/5/1
Y1 - 2018/5/1
N2 - Background Referral letters sent from primary to secondary or tertiary care are a crucial element in the continuity of patient information transfer. Internationally, the need for improvement in this area has been recognised. This aim of this study is to review the current literature pertaining to interventions that are designed to improve referral letter quality.Methods A search strategy designed following a Problem, Intervention, Comparator, Outcome model was used to explore the PubMed and EMBASE databases for relevant literature. Inclusion and exclusion criteria were established and bibliographies were screened for relevant resources.Results A total of 18 publications were included in this study. Four types of interventions were described: electronic referrals were shown to have several advantages over paper referrals but were also found to impose new barriers; peer feedback increases letter quality and can decrease 'inappropriate referrals' by up to 50%; templates increase documentation and awareness of risk factors; mixed interventions combining different intervention types provide tangible improvements in content and appropriateness.Conclusion Several methodological considerations were identified in the studies reviewed but our analysis demonstrates that a combination of interventions, introduced as part of a joint package and involving peer feedback can improve.
AB - Background Referral letters sent from primary to secondary or tertiary care are a crucial element in the continuity of patient information transfer. Internationally, the need for improvement in this area has been recognised. This aim of this study is to review the current literature pertaining to interventions that are designed to improve referral letter quality.Methods A search strategy designed following a Problem, Intervention, Comparator, Outcome model was used to explore the PubMed and EMBASE databases for relevant literature. Inclusion and exclusion criteria were established and bibliographies were screened for relevant resources.Results A total of 18 publications were included in this study. Four types of interventions were described: electronic referrals were shown to have several advantages over paper referrals but were also found to impose new barriers; peer feedback increases letter quality and can decrease 'inappropriate referrals' by up to 50%; templates increase documentation and awareness of risk factors; mixed interventions combining different intervention types provide tangible improvements in content and appropriateness.Conclusion Several methodological considerations were identified in the studies reviewed but our analysis demonstrates that a combination of interventions, introduced as part of a joint package and involving peer feedback can improve.
KW - communication
KW - health systems
KW - primary care
KW - primary-secondary care interface
KW - quality
KW - referral letters
UR - http://www.scopus.com/inward/record.url?scp=85038012924&partnerID=8YFLogxK
U2 - 10.1017/S1463423617000755
DO - 10.1017/S1463423617000755
M3 - Review article
C2 - 29212565
AN - SCOPUS:85038012924
SN - 1463-4236
VL - 19
SP - 211
EP - 222
JO - Primary Health Care Research and Development
JF - Primary Health Care Research and Development
IS - 3
ER -