Care delivery is a complex process, involving many different actors (physicians, nurses,…). Appropriate communication between those actors is of key to guarantee qualitative and thus safe care. Referral letters are one of the most important means of communication between care providers. The aim of this study was to perform a qualitative assessment of the content of referral letters (second to first level providers) of patients with chronic fatigue and a psychiatric disorder.
Methods:
The study was conducted by the head nurse of the department of General Internal Medicine of Ghent University Hospital. Based on a comprehensive search of the literature, a checklist of respectively 24 quality indicators was developed assessing the content and way of interdisciplinary communication between -second and first level providers. Indicators were considered as dichotomous variables (present/absent). All referral letters (June 2010–February 2011) of 126 patients with chronic fatigue and a psychiatric disorder were considered.
Results:
The study cohort consisted of 108 (85.7%) females, mean age was 39.3±11.1 years. Of the 24-item
checklist, on average 18.7±2.1 of the indicators were present. Telephone number of the referring
physician was never included 0% (0/126), reason of initial referral was not mentioned in
96%(121/126) of the letters. Information about allergic status was missing in 42.9%(54/126), current
medication in 17.5%(22/126), surgical and medical history in 34.1%(43/126) and 9.5%(12/126) of the
cases. Psychosocial information was not included in 22.2%(28/126) and 63.5%(80/126) of the letters
did not mention the dates investigations were performed. Average time-delay between consultation
with secondary care provider and sending the referral letter was 44.2±47.7 days .
Conclusion:
In this patient sample, referral letters from secondary to primary care level providers often lack
crucial information that is of key to ensure high quality of patient care. Targeted interventions aimed
at improving communication inefficiencies between multidisciplinary care levels are warranted.
See more of: Research Sessions: Oral Paper & Posters