Teaching referral skills to medical students

Bradley, Victoria; Whitelaw, Ben; Lindfield, Dan; Phillips, Richard J W; Trim, Corinne; Lasoye, Tunji

doi:10.1186/s13104-015-1369-4

Cited by 8 publications

(8 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…EWS is cited by clinical staff as a way to facilitate deterioration communication and package information, but care delays because of poor communication remain significant . Referral is high risk, with significant errors likely to occur and failures being directly attributable to incomplete information . In recognition of this problem, tools have been developed to improve communication during referral, such as Situation, Background, Assessment, and Recommendation (SBAR)…”

Section: Introductionmentioning

confidence: 99%

A qualitative exploration of escalation of care in the acute ward setting

Ede

Jeffs

Vollam

et al. 2019

Nursing in Critical Care

View full text Add to dashboard Cite

Background: "Failure to Rescue" includes failing to prevent avoidable patient deterioration and death. Despite its use, delays in care escalation still affect patient outcomes.Aims and Objective: The aim of this qualitative service evaluation was to map the barriers and facilitators to the escalation of care in the acute ward setting and identify those that are modifiable.Design: A total of 55 hours of qualitative observations were completed to capture care escalation events. These were conducted at two hospital sites in one National Health Service trust.Methods: Observations were iterative, with research team meetings being used to discuss the data and future methods. Field notes were analysed thematically by two researchers, extracting data on barriers and facilitators to escalation of care. Results: Clinical nursing staff challenged the sensitivity and specificity of Early Warning Scores, describing tool failings in certain clinical scenarios. Staff did not escalate based on the alerting Early Warning Scores alone but used other clinical factors, such as bleeding, which are not necessarily captured in the scoring systems. Staff frequently did not re-escalate low-level scores. Patient and non-patient factors identified as posing barriers to escalation were complex care needs, patient outlier status, and involvement of multiple care teams. Factors negatively affecting the chain of communication during escalation were team tension, staffing levels, and inadequate handover. Conclusion: This service evaluation identified barriers and facilitators to the escalation of care in the acute ward setting. Unlike other studies, we found that re-escalation or tracking of deterioration was problematic. Patients identified as being at a higher risk of escalation failure included complex patients, outliers, and patients with multiple care teams. Relevance to clinical practice: This service evaluation demonstrates continuing health care communication barriers. Patient groups (complex patients and outliers) risk process failures during escalation. This can be applied in clinical practice by staff anticipating problems in these patients, documenting clear escalation pathways. K E Y W O R D S acute ward, deterioration, escalation of care, observations, qualitative

show abstract

Section: Introductionmentioning

confidence: 99%

A qualitative exploration of escalation of care in the acute ward setting

Ede

Jeffs

Vollam

et al. 2019

Nursing in Critical Care

View full text Add to dashboard Cite

show abstract

“…Its main cause is to reduce the overload on hospitals. Nevertheless, many hospital consultation clinics are still overloaded with patients who could reach there without a referral (16).…”

Section: Discussionmentioning

confidence: 99%

Practice and Opinion of Doctors in Primary Health Care Centers Toward Referral System: Samples from Nine Governorates in Iraq

Al-Shatari¹,

Hasan²,

Shwaish

et al. 2021

Al-Kindy Col. Med. J

View full text Add to dashboard Cite

Background: Most primary Health Care Centers (PHCCs) in Iraq have a referral system records; however, this mechanism does not function well because of the lack of other requirements for an efficient referral system. Objective: To assess the practice & opinion of doctors in PHCs toward the referral system, and to determine the doctors in PHC's commitment to referral system instructions and guidelines. Subjects and methods: A cross-sectional study with analytic elements was conducted in nine health directorates in Iraq, from the 1st October 2018 – 30th June 2019.One PHC was selected randomly form each sector in every governorate, A questionnaire was used to collect the required information. SPSS version 24 analysis was used for the statistical analysis. Results: sixty-three doctors were working in PHCs had participated in the current study, the mean age (40.03 ±10.24), 58.7%were female, 46% were general practitioner, 30.2% of the participated doctors had 300 and less patient/month; 31.7% of doctors had ≤10 Patients referred/month, emergencies was the main cause for referral (46.03%), and 37(58.37%) of doctors announced that the referred-form not retrained to the PHC, and ever retrained-forms had no feedback 29(46%), 28(44%)of the participated doctors agreed that the current referral-system was effective and seven of them strongly agreed, 59(93.7%) believe in the importance of hospital-feedback, with a significant relationship between their attitude about the effective-current-referral system & Refer cases Percentage, while no significant-relation with their Patients examined/month. Loaded crowded and hospital doctors shortage as possible causes and suggest to referral-system activation especially the hospital -part". Conclusions: there was inadequate knowledge of referral-policies and lack of coordination or/and clear feedback-expectations and PHCs-hospitals collaboration and lack of referral-system integrated within an electronic-health-record.

show abstract

“…3,4 A survey among final year medical students revealed that two-thirds of the participating final year medical students had received no previous training in referral skills and recommended the inclusion of training in referral skills to their curriculum. 5 Therefore, it is recommended that EM residents should be formally imparted instruction on telephone consultation skills related to inpatient specialties. 5,6 Learner-centred experiential sessions that necessitate the active engagement of resident physicians constitute the most effective approaches in teaching communication skills and can lead to behavioural changes.…”

Section: Introductionmentioning

confidence: 99%

“…5 Therefore, it is recommended that EM residents should be formally imparted instruction on telephone consultation skills related to inpatient specialties. 5,6 Learner-centred experiential sessions that necessitate the active engagement of resident physicians constitute the most effective approaches in teaching communication skills and can lead to behavioural changes. 7 A one-to-one experiential session involves direct observation of a learner's telephone referral experience by an experienced EP, followed by appropriate and timely feedback and discussion.…”

Section: Introductionmentioning

confidence: 99%