Document Detail

Referral letters: are we prioritizing consistently?
MedLine Citation:
PMID:  15949102     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To determine the levels of intra- and inter-grade variability of the vetting of general practice (GP) letters as well as the intra-rater reliability of letter prioritization. DESIGN: Prospective assessment of letter vetting and questionnaire survey. SETTING: Three otolaryngology secondary referral centres in Bristol and Bath, UK. PARTICIPANTS: Twelve consultants, nine registrars, four staff and associate specialists (SAS) and 16 senior house officers (SHOs) in otolaryngology. METHODS: Fifty GP letters (not including 'fast-track' referrals) addressed to one of the ENT departments were chosen sequentially. These were anonymized, photocopied and included in the questionnaire to all participating staff. Participants were asked to vet the letters as 'urgent', 'soon' or 'routine' according to supplied waiting time criteria. The same letters were sent out again six weeks later. RESULTS: There was no significant difference between grades for the mean number of letters vetted into each category. Intra-grade variability was high; the number of letters vetted urgent varied from one out of 50 to 15 out of 50 for the consultants. The intra-rater reliability was high. CONCLUSION: The grade of trainee seems to make little difference with regard to ability to prioritize referrals, but within grades there is little agreement on what constitutes an urgent referral. We suggest further research, looking at the final outcome of patients, needs to be done to try to establish evidence-based guidelines to assist with letter vetting.
David D Pothier; Costa Repanos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of laryngology and otology     Volume:  119     ISSN:  0022-2151     ISO Abbreviation:  J Laryngol Otol     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-06-13     Completed Date:  2005-07-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8706896     Medline TA:  J Laryngol Otol     Country:  England    
Other Details:
Languages:  eng     Pagination:  377-80     Citation Subset:  AIM; IM    
Department of Otolaryngology, Gloucestershire Royal Hospital, Gloucester, UK.
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MeSH Terms
Correspondence as Topic*
Family Practice
Health Priorities / organization & administration
Medical Records
Medical Staff, Hospital
Professional Practice / standards
Prospective Studies
Referral and Consultation / organization & administration*

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