What's in a referral letter: does the detail matter?

Dickie, JA; Ellwood, DA; Robertson, Meiri

doi:10.1002/j.2205-0140.2011.tb00117.x

Cited by 8 publications

(4 citation statements)

References 12 publications

(15 reference statements)

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“…These actions should be outlined in the Standard Operating Procedures (SOPs) of the Referral Process in PHC [5], [21]. PHC can also create a better and easier-to-fill reference letter template equipped with an observation/monitoring sheet during the transfer process [22], [23], [24]. According to a study in Norway, referral letter templates can improve the quality of referrals from primary health facilities [25].…”

Section: Discussionmentioning

confidence: 99%

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Public Health Center Emergency Referral Quality Analysis: Based on National Standard

Sasmito,

Prasetya,

Yektiningtyastuti

et al. 2024

Int Jou of PHE

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The referral quality will affect the outcome of referred patients. The quality of emergency referrals from the Public Health Center (PHC) in Banten Province has not been examined. This study aims to analyze the quality of emergency referrals from PHC and the factors that influence it. Observational analytics with a retrospective approach to a PHC in Banten Province, Indonesia. The reference data for March-May 2023 is taken consecutively. Data on the demographics of referrers and referral cases are recorded. The quality of referrals is analyzed using national personal referral standards. A total of 52 referral cases were involved in the study. Referrals were made by nurses with an average age of 28.2 years with a range of 23-43 years, men (38/73.1%), and with diploma education (30/57.7%). Most of the referring nurses have a valid Basic Life Support (BLS) certificate (46/88.5), are non-civil servants, and work for an average of 3.3 years. Most of the referred cases are surgical (28/53.8) and urgency cases (32/61.5). Forty-four referral cases (84.6%) did not meet national referral standards. The referring nurse's educational background and the urgency of the case had a significant relationship with the quality of referrals with p values < α values of 0.05 (0.000 and 0.000 respectively). There was no significant relationship between referral quality and patient/family satisfaction. Conclusion: Most PHC's emergency referrals to hospital emergency departments (ED) have not complied with national standards. There was a significant relationship between the education of the referring nurse and the level of urgency of the case with the quality of PHC referrals. There is no relationship between referral quality and patient/family satisfaction. National technical guidelines for individual referrals for emergency cases are needed.

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Section: Discussionmentioning

confidence: 99%

“…In addition, accurate information should be collected in the fastest time possible. So, all forms of patient data obtained by previous health facilities are important for health workers at the next level [9], [10]. Therefore, quality and standard-compliant emergency referrals should be an obligation for referral organizers.…”

Section: Introductionmentioning

confidence: 99%

Public Health Center Emergency Referral Quality Analysis: Based on National Standard

Sasmito,

Prasetya,

Yektiningtyastuti

et al. 2024

Int Jou of PHE

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“…Different studies argued about qualified referral letters which depend generally on the content of information [10][11][12]. The quantity and quality of information contained in the referral letters have a considerable impact on the coordination and continuity of care and hence also on successful healthcare service outcome [13,14]. According to the World Health Organization (WHO), the referral form is designed to facilitate communication and should clearly record patient identification, clinical findings, treatment given, specific reason for referral and clearly mention the initiating and receiving facilities.…”

Section: Introductionmentioning

confidence: 99%

Assessment of formats and completeness of paper-based referral letters among urban hospitals in Rwanda: a retrospective baseline study

Kalume

Jansen

Nyssen

et al. 2022

BMC Health Serv Res

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Background Patient referral is a process in which a healthcare provider decides to seek assistance due to the limitations of available skills, resources and services offered locally. Paper-based referrals predominantly used in low-income countries hardly follow any procedure. This causes a major gap in communication, coordination, and continuity of care between primary and specialized levels, leading to poor access, delay, duplication and unnecessary costs. The goal of this study is to assess the formats and completeness of existing paper-based referral letters in order to improve health information exchange, coordination, and continuity of care. Methods A retrospective exploratory research was conducted in eight public and three private healthcare facilities in the city of Kigali from May to October 2021. A purposive sampling method was used to select hospitals and referral letters from patients’ files. A data capture sheet was designed according to the contents of the referral letters and the resulting responses were analyzed descriptively. Results In public hospitals, five types of updated referral letters were available, in total agreement with World Health Organization (WHO) standards of which two (neonatal transfer form and patient monitoring transfer form) were not used. There was also one old format that was used by most hospitals and another format designed and used by a district hospital (DH) separately. Three formats were designed and used by private hospitals (PH) individually. A total of 2,304 referral letters were perused and the results show that “external transfer” forms were completed at 58.8%; “antenatal, delivery, and postnatal external transfer” forms at 47.5%; “internal transfer” forms at 46.6%; “Referral/counter referral” forms at 46.0%; district hospital referrals (DH2) at 73.4%. Referrals by private hospitals (PH1, PH2 and PH3) were completed at 97.7%, 70.7%, and 0.0% respectively. The major completeness deficit was observed in counter referral information for all hospitals. Conclusion We observed inconsistencies in the format of the available referral letters used by public hospitals, moreover some of them were incompatible with WHO standards. Additionally, there were deficits in the completeness of all types of paper-based referral letters in use. There is a need for standardization and to disseminate the national patient referral guideline in public hospitals with emphasis on referral feedback, referral registry, triage, archiving and a need for regular training in all organizations.

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“…High-quality referral and consultation processes require good communication between healthcare providers: this may lead to reduced delays in the diagnostic care pathway, high-quality continuity of care and improved patient's satisfaction [3]. The interaction between general medical practitioner (GMP) and specialist physician is based on the recommendation letters where there is the patient's clinical history, the description of symptoms and a provisional diagnostic hypothesis [4]. In medicine, the analysis of referral patterns is a relevant and current issue as it is closely connected to the quality of healthcare and its costs [5].…”

Section: Introductionmentioning

confidence: 99%

Referral Patterns in Oral Medicine: A Retrospective Analysis of an Oral Medicine University Center in Southern Italy

Coppola

Baldares

Blasi

et al. 2021

IJERPH

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Referral of a patient from one healthcare provider to another is an important part of the medical practice. The aim of this study was to analyze the referral process to the Oral Medicine Unit in a university-based tertiary center in Southern Italy. A chart review of new referrals to the Oral Medicine Unit during a 24-month period was conducted. The following data were recorded: demographic characteristics, medical history, number of physicians seen prior to Oral Medicine assessment, referral source, diagnostic procedures ordered by referrals, reason for referral, site of lesion/condition, final diagnosis. Then, the rates of correct identification for health-care professionals and the appropriateness of the reference diagnosis based on the disease were calculated with descriptive statistic indicators. There were 583 new first consultations. A total of 62.9% of patients were referred by general dental practitioners, 27.4% by physicians, and 9.7% did not have a referral. The most common diseases for referral were immune-mediated diseases (39.6%) and oro-facial pain disorders (25.2%). Only 28.5% of patients had a correct provisional diagnosis. The results of this study show the need to implement curricula in the field of oral medicine among dentistry and medical students, and to support the continuing education among healthcare providers to reduce diagnostic delay for oral diseases.

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What's in a referral letter: does the detail matter?

Cited by 8 publications

References 12 publications

Public Health Center Emergency Referral Quality Analysis: Based on National Standard

Public Health Center Emergency Referral Quality Analysis: Based on National Standard

Assessment of formats and completeness of paper-based referral letters among urban hospitals in Rwanda: a retrospective baseline study

Referral Patterns in Oral Medicine: A Retrospective Analysis of an Oral Medicine University Center in Southern Italy

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