دورية أكاديمية
Junior doctor-led quality improvement project to improve safety and visibility of an interspecialty referral system.
| العنوان: | Junior doctor-led quality improvement project to improve safety and visibility of an interspecialty referral system. |
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| المؤلفون: | Kwon D; South Bristol Academy/Undergraduate Education Department, Trust Services, Bristol Royal Infirmary, Bristol, UK., Moon WY; Department of Ophthalmology, Royal Berkshire NHS Foundation Trust, Reading, UK., Akhunbay-Fudge M; Department of Acute Internal Medicine, Wexham Park Hospital, Slough, UK., Pieters B; Musgrove Park Academy, Somerset NHS Foundation Trust, Taunton, UK., Pillai J; Department of Psychiatry, Homerton University Hospital, East London Foundation Trust, London, UK., Wilson C; Department of Anaesthetics, Somerset NHS Foundation Trust, Taunton, UK., Morrison J; Department of Gynaecological Oncology, Somerset NHS Foundation Trust, Taunton, UK jo_morrison@doctors.org.uk. |
| المصدر: | BMJ open quality [BMJ Open Qual] 2021 Jul; Vol. 10 (3). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Publishing Group Country of Publication: England NLM ID: 101710381 Publication Model: Print Cited Medium: Internet ISSN: 2399-6641 (Electronic) Linking ISSN: 23996641 NLM ISO Abbreviation: BMJ Open Qual Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BMJ Publishing Group |
| مواضيع طبية MeSH: | Quality Improvement* , Referral and Consultation*, Electronic Health Records ; Humans ; Inpatients |
| مستخلص: | Interspecialty referrals for increasingly complex hospital inpatients are common and miscommunication often leads to delays in patient care. In a district general hospital, a web-based system generated an email referral, which lacked visibility and tracking/audit of the process, with no record generated automatically in paper inpatient notes or electronic patient records (EPR). We aimed to improve the visibility and safety of the interspecialty referral system.We canvassed stakeholders, informally and via an online satisfaction survey, collecting qualitative and quantitative data about attitudes to the existing system, generating ideas for change. We process mapped the system, identifying points of weakness. We adapted our EPR system, using a work-around solution, to develop a form that could be emailed from the EPR. This generated a permanent record within the EPR and an electronic record of the referral having been sent. We measured the visibility of referrals and responses within the EPR. We generated an online training 'how-to' video and reaudited stakeholder satisfaction.There was a significant increase in the proportion of junior doctors satisfied or very satisfied with the interspecialty referral system (27/31 postintervention; 87.1% vs 26/55 preintervention; 47%; p<0.0001) and more believed that the visibility was adequate or very adequate (24/31 postintervention; 77.4% vs 9/55 preintervention; 16.4%; p<0.0001). Visibility of referrals by project team members on the EPR increased from a baseline of 3.5% to 83.6% and the visibility of responses to these referrals on the EPR increased from 4.6% to 40.7%. Qualitative feedback was excellent, hospital executive approval was gained and our work-around system spread to non-team members.We developed a more visible and reliable interspecialty referral system, adapting existing EPR capabilities, which was popular with users and led to cultural change in interspecialty referral responders. A formal EPR redesign, informed by our project, is in development. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.) |
| References: | Postgrad Med J. 2019 Jan;95(1119):1-5. (PMID: 30674619) J Hosp Med. 2018 Mar 26;13(8):570-572. (PMID: 29578553) Postgrad Med J. 2019 May;95(1123):292. (PMID: 30992416) Ochsner J. 2015 Summer;15(2):149-53. (PMID: 26130977) BMJ Qual Improv Rep. 2016 Apr 07;5(1):. (PMID: 27158494) Emerg Med J. 2005 May;22(5):355-8. (PMID: 15843705) BMJ Open Qual. 2018 Sep 28;7(3):e000249. (PMID: 30306139) |
| فهرسة مساهمة: | Keywords: communication; efficiency; electronic health records; organisational; patient safety; quality improvement |
| تواريخ الأحداث: | Date Created: 20210714 Date Completed: 20210929 Latest Revision: 20210929 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC8278895 |
| DOI: | 10.1136/bmjoq-2020-001323 |
| PMID: | 34257073 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2399-6641 |
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| DOI: | 10.1136/bmjoq-2020-001323 |