Referral letters in oral medicine: standard versus non-standard letters

Navarro, Cláudia Maria; Miranda, Ian; Onofre, Mirian Aparecida; Sposto, M. R.

doi:10.1054/ijom.2002.0277

Cited by 21 publications

(30 citation statements)

References 15 publications

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“…Research has shown that the use of pro forma letters result in shorter but more comprehensive referral letters. 1,6,13 The response to better quality referral letters varies. Some studies found that better quality letters received more replies.…”

Section: • Factors Concerning Referralmentioning

confidence: 99%

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Why doctors do not answer referral letters

Smith

Khutoane

2009

South African Family Practice

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Background: Healthcare workers at primary healthcare (PHC) clinics are frustrated by the fact that they do not receive replies to their referral letters to doctors. Referral letters act as permission slips to allow patients easy access to treatment by specialists at secondary and tertiary service levels and communicate reasons for referral. Reply to the referral letter is vital for continuity of care to be maintained and to enable comprehensive recording at PHC level. It has been found that poor feedback leads to poor follow-up care in the PHC setting. Previous research has investigated the influence of the method of communication, either by use of pro forma letters or by electronic feedback on answers. The study on which this article is based endeavoured to understand the receiving doctors' reasons for not replying to referral letters and the context contributing to this problem. If this matter could be resolved it would relieve frustration at PHC level and improve healthcare services in future.Methods: A qualitative study method was used, as the purpose of this study was to understand and explore in depth doctors' context, perceptions and motivation for not answering referral letters. In-depth interviews were conducted with six purposefully selected doctors who all had more than one year's experience in their different departments. The exploratory question posed was: "What factors are contributing to not replying to referrals from primary healthcare clinics?" Interviews were tape-recorded and transcribed verbatim. Themes were identified using the Tesch method. Analysis was done independently by two coders, who afterwards reached consensus on identified themes. After analysis of each interview, reliability was further ensured by going back to the participants to verify that the interpretation represents an accurate description of the participant's view. Results:The participants included one consultant and five registrars with between 18 months and 8 years' experience in their departments. According to participants, many reasons contributed to their not writing answers to referrals. The reasons for not replying to referral letters pertained to the working situation at the referral hospital and factors regarding the referrals themselves on the one hand and the hospital doctor's perceptions as to his/her role in the healthcare system and his/her perception that it is futile to answer referrals on the other.Conclusions: There were multiple reasons for doctors not replying to referral letters. The referring personnel can address some of these reasons by ensuring accurate referrals on appropriate days, considering style preferences of the hospital doctors and by the use of pro forma letters. Hospital consultants can address other factors by giving attention to the socialisation of their juniors and by adjusting the referral system so that it does not rely on patients to courier letters. Further research needs to be undertaken in South Africa to assess the influence of various methods of communication in the r...

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Section: • Factors Concerning Referralmentioning

confidence: 99%

“…Previous research has investigated the influence of the method of communication, either by use of pro forma letters or by electronic feedback on answers. 5,6 However, as long as the reasons for not replying are not specifically identified and addressed, personnel at PHC services will remain frustrated by the silence from secondary …”

Section: Introductionmentioning

confidence: 99%

Why doctors do not answer referral letters

Smith

Khutoane

2009

South African Family Practice

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

2018

Br Dent J

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Poor description of oral lesions jeopardize the prioritization of appointments in Oral Medicine. The present study investigated whether the use of support tools changes the quality of descriptions focusing on health care prioritization. Two oral lesions (A and B) were described by 64 dental students and 48 dentists using three methods: (a) without support tools (free); (b) using the oral examination form from the Specialties Manual in Oral Health/Brazilian Ministry of Health (SMOH form); and (c) using the OralDESC guideline. The descriptions were compared with a gold standard and percentage of agreement was analyzed by the Kruskal-Wallis and Dunn's tests (p<0.05). Descriptions with the OralDESC presented higher information quality. Considering items essential for prioritization, the OralDESC demonstrated better performance for lesion A; for lesion B, free descriptions and descriptions using the OralDESC were of higher quality than those using SMOH form. Therefore, the OralDESC offered greater support for the description of oral lesions for health care prioritization in Oral Medicine.

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“…Recent studies into the quality of oral medicine referrals by Navarro et al, 3,4 which compared the use of standard and non-standard referral letters to oral medicine specialists, found that standard letters were more complete and contained important information commonly absent in non-standard letters. However, the studies also revealed that regardless of the type of referral letter, much of the essential information that one would expect in any referral letter was generally omitted (eg the patient's age and address).…”

Section: Introductionmentioning

confidence: 99%

“…This may potentially lead to delays in patient diagnosis and treatment. 3,4 In considering how oral medicine referrals could be improved we have encountered the use of telemedicine as a potential solution in helping the referrer improve referral into the specialist arena. Telemedicine is a broad term that encompasses the use of telecommunication in doctor-patient as well as doctor-doctor interaction.…”

Section: Introductionmentioning

confidence: 99%