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Electronic optional guidelines as a tool to improve the process of referring patients to specialized care: an intervention study.

Rokstad IS, Rokstad KS, Holmen S, Lehmann S, Assmus J - Scand J Prim Health Care (2013)

Bottom Line: The GPs did not know that their referrals were being evaluated.The specialists reported significantly higher referral quality and considerably less time spent on evaluating referrals when using the EOGT, with an overall time reduction of 34%.In fact, the tool may be even more beneficial for the GP.

View Article: PubMed Central - PubMed

Affiliation: Haukeland University Hospital, Norway.

ABSTRACT

Objective: The main objective of this paper is to investigate whether incorporating an electronic optional guideline tool (EOGT) in the standardized referral template used by general practitioners (GPs) when referring patients to specialized care can improve outpatient referral appropriateness.

Design: Intervention study with an intervention and a control group.

Setting: 210 GPs in the municipality of Bergen and the Department of Thoracic Medicine at Haukeland University Hospital.

Subjects: 2400 patients referred to the Department of Thoracic Medicine at Haukeland University Hospital.

Results: An electronic optional guideline tool (EOGT) was implemented on 93 of 210 GPs' computer systems. The referral quality and the time spent reviewing each referral were evaluated by the hospital specialists. The GPs did not know that their referrals were being evaluated. The specialists were blinded with regard to information concerning the intervention and the control group. The specialists reported significantly higher referral quality and considerably less time spent on evaluating referrals when using the EOGT, with an overall time reduction of 34%. Likewise, GPs also reported that the EOGT was easy to use, time-saving and led to an improved quality of their referrals.

Conclusion: This study documents an improvement in the quality of the referrals. Since the GPs save time by using the EOGT, there is no reason to believe that they will discontinue using it. In fact, the tool may be even more beneficial for the GP. The authors believe that it is possible to implement the EOGT as a standard referral tool within various fields of medicine and are currently in the process of developing these tools.

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Related in: MedlinePlus

Percentage of the answers to questions 3–10 for sleep apnoea, chronic obstructive pulmonary disease, and lung tumours in the intervention and the non-intervention group in numbers and percentages with p-values of the chi-squared test (*) or Fisher's exact test (**).
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Figure 3: Percentage of the answers to questions 3–10 for sleep apnoea, chronic obstructive pulmonary disease, and lung tumours in the intervention and the non-intervention group in numbers and percentages with p-values of the chi-squared test (*) or Fisher's exact test (**).

Mentions: Two of the parameters regarding lung tumours showed no significant differences, namely chest X-ray (p = 0.142) and CT thorax (p = 0.234) (Figure 3). All other parameters showed significant differences (Figure 3).


Electronic optional guidelines as a tool to improve the process of referring patients to specialized care: an intervention study.

Rokstad IS, Rokstad KS, Holmen S, Lehmann S, Assmus J - Scand J Prim Health Care (2013)

Percentage of the answers to questions 3–10 for sleep apnoea, chronic obstructive pulmonary disease, and lung tumours in the intervention and the non-intervention group in numbers and percentages with p-values of the chi-squared test (*) or Fisher's exact test (**).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750439&req=5

Figure 3: Percentage of the answers to questions 3–10 for sleep apnoea, chronic obstructive pulmonary disease, and lung tumours in the intervention and the non-intervention group in numbers and percentages with p-values of the chi-squared test (*) or Fisher's exact test (**).
Mentions: Two of the parameters regarding lung tumours showed no significant differences, namely chest X-ray (p = 0.142) and CT thorax (p = 0.234) (Figure 3). All other parameters showed significant differences (Figure 3).

Bottom Line: The GPs did not know that their referrals were being evaluated.The specialists reported significantly higher referral quality and considerably less time spent on evaluating referrals when using the EOGT, with an overall time reduction of 34%.In fact, the tool may be even more beneficial for the GP.

View Article: PubMed Central - PubMed

Affiliation: Haukeland University Hospital, Norway.

ABSTRACT

Objective: The main objective of this paper is to investigate whether incorporating an electronic optional guideline tool (EOGT) in the standardized referral template used by general practitioners (GPs) when referring patients to specialized care can improve outpatient referral appropriateness.

Design: Intervention study with an intervention and a control group.

Setting: 210 GPs in the municipality of Bergen and the Department of Thoracic Medicine at Haukeland University Hospital.

Subjects: 2400 patients referred to the Department of Thoracic Medicine at Haukeland University Hospital.

Results: An electronic optional guideline tool (EOGT) was implemented on 93 of 210 GPs' computer systems. The referral quality and the time spent reviewing each referral were evaluated by the hospital specialists. The GPs did not know that their referrals were being evaluated. The specialists were blinded with regard to information concerning the intervention and the control group. The specialists reported significantly higher referral quality and considerably less time spent on evaluating referrals when using the EOGT, with an overall time reduction of 34%. Likewise, GPs also reported that the EOGT was easy to use, time-saving and led to an improved quality of their referrals.

Conclusion: This study documents an improvement in the quality of the referrals. Since the GPs save time by using the EOGT, there is no reason to believe that they will discontinue using it. In fact, the tool may be even more beneficial for the GP. The authors believe that it is possible to implement the EOGT as a standard referral tool within various fields of medicine and are currently in the process of developing these tools.

Show MeSH
Related in: MedlinePlus