- Title
- Impact of referral letters on scheduling of hospital appointments: a randomised control trial
- Creator
- Jiwa, Moyez; Meng, Xingqiong; O'Shea, Carolyn; Magin, Parker; Dadich, Ann; Pillai, Vinita
- Relation
- British Journal of General Practice Vol. 64, Issue 624, p. e419-e425
- Publisher Link
- http://dx.doi.org/10.3399/bjgp14X680509
- Publisher
- Royal College of General Practitioners
- Resource Type
- journal article
- Date
- 2014
- Description
- Background: Communication is essential for triage, but intervention trials to improve it are scarce. Referral Writer (RW), a referral letter software program, enables documentation of clinical data and extracts relevant patient details from clinical software. Aim: To evaluate whether specialists are more confident about scheduling appointments when they receive more information in referral letters. Design and setting: Single-blind, parallel-groups, controlled design with a 1:1 randomisation. Australian GPs watched video vignettes virtually. Method: GPs wrote referral letters after watching vignettes of patients with cancer symptoms. Letter content was scored against a benchmark. The proportions of referral letters triagable by a specialist with confidence, and in which the specialist was confident the patient had potentially life-limiting pathology were determined. Categorical outcomes were tested with χ2 and continuous outcomes with t-tests. A random-effects logistic model assessed the influence of group randomisation (RW versus control), GP demographics, clinical specialty, and specialist referral assessor on specialist confidence in the information provided. Results: The intervention (RW) group referred more patients and scored significantly higher on information relayed (mean difference 21.6 [95% confidence intervals {CI} = 20.1 to 23.2]). There was no difference in the proportion of letters for which specialists were confident they had sufficient information for appointment scheduling (RW 77.7% versus control 80.6%, P = 0.16). In the logistic model, limited agreement among specialists contributed substantially to the observed differences in appointment scheduling (P = 35% [95% CI 16% to 59%]). Conclusion: In isolation, referral letter templates are unlikely to improve the scheduling of specialist appointments, even when more information is relayed.
- Subject
- decision making; general practice; interdisciplinary correspondence; neoplasms; randomised control trial; referral and consultation
- Identifier
- http://hdl.handle.net/1959.13/1304587
- Identifier
- uon:20874
- Identifier
- ISSN:0960-1643
- Language
- eng
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