Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study - protocol of a mixed methods study

Abstract

BackgroundAs the first point of contact for patients and witnesses of stroke, General Practice receptionists can be instrumental in deciding the urgency of clinical contact. Despite the considerable complexity of this task, reception staff are not clinically trained. Minimising the time taken to access thrombolysis is crucial in acute stroke as treatment must be initiated within 4.5 hours of the onset, and the earlier the better, to achieve the best outcomes. Research suggests that patients who first contact their General Practice following the onset of stroke symptoms are less likely to receive thrombolysis, in part due to significant delays within Primary Care.This study therefore aims to understand the role of General Practice receptionists, with particular interest in receptionist’s ability to recognise people who may be suffering from a stroke and to handle such patients as a medical emergency.MethodsThe Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study will be a Primary Care based mixed methods study. 60 General Practices in the West Midlands will be recruited. Each practice will receive 10 unannounced simulated patient telephone calls, after the 10 calls questionnaires will be administered to each receptionist. These will examine the behaviour of receptionists towards patients presenting in Primary Care with stroke symptoms, and their knowledge of stroke symptoms. An embedded qualitative study will use interviews and focus groups to investigate the views of General Practice staff on the receptionists’ role in patient referral and whether training in this area would be helpful.DiscussionThe results of the RECEPTS study will have important implications for providers of Primary Care. The study will establish current practice in UK primary care in terms of General Practice receptionists’ knowledge of the presentation and appropriate referral of those who may be suffering a stroke. It will highlight training needs and how such training might be best delivered.

A quantitative assessment of the parameters of the role of receptionists in modern primary care using the work design framework

“…Increasingly, modern surgeries are multi-disciplinary teams consisting of clinical and non-clinical staff each undertaking a range of inter-related tasks to successfully deliver care [ 38 – 41 ]. As such the work the receptionist undertakes is varied [ 9 – 11 , 42 – 45 ] and straddles both clinical and non-clinical responsibilities [ 9 – 11 , 14 , 16 – 19 , 43 , 46 – 51 ]. In doing so the receptionist juggles multiple sources of information from patients, colleagues, and external agencies often with competing demands on attention; for example booking patients into the practice while simultaneously taking phone calls [ 17 , 52 ].…”

“…As a result, staff are now delivering care in a far more complex and dynamic environment with implications for clinical and non-clinical members of the primary care team. Amongst the most visible of these are receptionists who not only undertake an array of administrative duties [9,10] but also fulfil clinically related tasks such as triaging patients, reporting results or administering screening [11][12][13][14][15][16][17][18][19] often without adequate training [10]. The failure of receptionists to successfully fulfil these responsibilities has potentially serious implications for patient outcomes and safety [15,[20][21][22].…”

A quantitative assessment of the parameters of the role of receptionists in modern primary care using the work design framework

“…Demand has now reached unprecedented levels (2,5) within an evolving model of service delivery that requires clinical and non-clinical members of the primary care team adapt to providing care in a far more complex and dynamic environment. (6)(7)(8) Amongst the most visible of these are receptionists who not only undertake an array of administrative duties (9, 10) but also fulfil clinically relevant tasks such as triaging patients, reporting results, or administering screening (11)(12)(13)(14)(15)(16)(17)(18)(19) all without any requisite qualifications (10). The failure of receptionists to successfully fulfil these responsibilities has potentially serious implications for patient outcomes and safety (15,(20)(21)(22).…”

A quantitative assessment of the parameters of the role of receptionists in modern primary care using the work design framework

“…As a result, staff are now delivering care in a far more complex and dynamic environment with implications for clinical and non-clinical members of the primary care team. Amongst the most visible of these are receptionists who not only undertake an array of administrative duties (9, 10) but also ful l clinically related tasks such as triaging patients, reporting results or administering screening (11)(12)(13)(14)(15)(16)(17)(18)(19) often without adequate training (10). The failure of receptionists to successfully ful l these responsibilities has potentially serious implications for patient outcomes and safety (15,(20)(21)(22).…”