Quality and contents of referral letters from peripheral health centers to the dental centre of a teaching hospital, southwestern Nigeria

Abstract

This study has shown that referral letters written from various peripheral healthcare centers to the dental centre of a teaching hospital is generally of unacceptable quality and the content could be improved upon.

The use of tools to support oral lesion description in oral medicine referrals

“…6 Referral documents are important and quite common instruments for exchange of information between professionals from different health care levels. 7,8,9 In some situations, referral documents are the only means available for this exchange, 10,11,12 and may also affect the quality of care offered to the patients. 9,10,13 The quality of these documents is therefore essential for proper health care, and its contents should allow assessing the clinical need and the urgency for appointments.…”

The use of tools to support oral lesion description in oral medicine referrals

“…9 In order to be useful, referral documents must provide organized information, rhetorical relevance, appropriate level of detail, and be concise. 12,14 However, several studies have reported that referral letters often lack important information, 7,8,9,10,12,13,15,16 which can result in problems such as improper scheduling, prioritization errors, 9,11,13 unnecessary repetition of tests 7 and, ultimately, inadequate care and delay in treating the illness. 10 Several studies aimed at defining the necessary information for the referral of patients.…”

“…12,14 However, several studies have reported that referral letters often lack important information, 7,8,9,10,12,13,15,16 which can result in problems such as improper scheduling, prioritization errors, 9,11,13 unnecessary repetition of tests 7 and, ultimately, inadequate care and delay in treating the illness. 10 Several studies aimed at defining the necessary information for the referral of patients. 8,9,10,12,16,17 Depending on the specialty, the clinical description of the lesion is considered essential.…”

“…10 Several studies aimed at defining the necessary information for the referral of patients. 8,9,10,12,16,17 Depending on the specialty, the clinical description of the lesion is considered essential. 9,12,13,16 Lesion details may include type (primary morphology), 13,16 size, 9,16 location, 12,13,16 color and eventual ulceration, 9,13 shape and consistency, 9 thickness, texture, presence of rolled margin (in the case of oral squamous cell carcinoma), 13 duration, 12,16 symptoms, 12,16 clinical diagnosis, 12,16 suspicion of malignancy, 17 risk factors for disease, and management details, such as use of medications/mouthwash, previous biopsy or denture/tooth adjustment.…”

“…9,12,13,16 Lesion details may include type (primary morphology), 13,16 size, 9,16 location, 12,13,16 color and eventual ulceration, 9,13 shape and consistency, 9 thickness, texture, presence of rolled margin (in the case of oral squamous cell carcinoma), 13 duration, 12,16 symptoms, 12,16 clinical diagnosis, 12,16 suspicion of malignancy, 17 risk factors for disease, and management details, such as use of medications/mouthwash, previous biopsy or denture/tooth adjustment. 13 Specific strategies have been suggested to improve the content of referral documents, such as the use of support tools, 6,10,16 investment in education and training of professionals, 6,10 and the use of electronic referrals. 8,18,19 Some studies evaluated the quality of the referral documents specifically within the Oral Medicine field.…”