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Impact of referral templates on patient experience of the referral and care process: A cluster randomised trial
- Source :
- BMJ Open
- Publication Year :
- 2016
- Publisher :
- BMJ Publishing Group, 2016.
-
Abstract
- Published version. Source at http://dx.doi.org/10.1136/ bmjopen-2016-011651 Objectives: To evaluate if a referral intervention improves the patient experience of the referral and treatment process. Setting: Interface between 14 primary care surgeries and a district general hospital. Participants: The 14 general practitioner (GP) surgeries (7 intervention, 7 control) in the area around the University Hospital of North Norway Harstad were randomised and all completed the study. Consecutive individual patients were recruited at their hospital appointment. A total of 500 patients were recruited with 281 in the intervention and 219 in the control arm. Interventions: Dissemination of referral templates for 4 diagnostic groups (dyspepsia, suspected colorectal cancer, chest pain and chronic obstructive pulmonary disease) coupled with intermittent surgery visits by study personnel. The control arm continued standard referral practice. The intervention was in use for 2.5 years. Outcome: The main outcome was a quality indicator score. This paper reports a secondary outcome, the patient experience, as measured by self-report questionnaires. GPs in the intervention group could not be blinded. Patients were blinded to intervention status. Analysis was based on single-question comparison with a questionnaire subscore used to assess the effect of clustering. Results: On the individual questions, overall satisfaction was very high with minor differences between the intervention and control group. Interestingly, the most negative responses, in both groups concerned questions relating to patient interaction and information. Very little evidence of clustering was found with an estimated intracluster correlations coefficient at 1.21e−11. Conclusions: In total, this indicates no clear effect of the implementation of referral templates on the patient experience, in a setting of generally high patient satisfaction.
- Subjects :
- Patient experience
Male
Psychological intervention
Chest pain
Hospitals, University
Pulmonary Disease, Chronic Obstructive
0302 clinical medicine
Surveys and Questionnaires
030212 general & internal medicine
Referral and Consultation
Norway
VDP::Medical disciplines: 700::Clinical medical disciplines: 750
030503 health policy & services
Health services research
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750
General Medicine
Middle Aged
Quality Improvement
Patient Satisfaction
Female
Health Services Research
medicine.symptom
0305 other medical science
Referral
Colorectal Neoplasms
Adult
medicine.medical_specialty
Chest Pain
Disease cluster
General practitioner
03 medical and health sciences
Patient satisfaction
General Practitioners
Intervention (counseling)
medicine
Humans
Dyspepsia
Aged
Quality of Health Care
Physician-Patient Relations
Primary Health Care
business.industry
Research
Physical therapy
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- BMJ Open
- Accession number :
- edsair.doi.dedup.....7357edfd0b579a5487bca70d4e60764c