An audit into improving current referral practices to the haematology department at Hillingdon Hospital

Divya Srinivasan; Khushi Sakhi; Sadaf Shaukat

doi:10.7861/fhj.9-2-s107

Background

The system used within the haematology department at Hillingdon Hospital relied on referrals conducted via pagers, potentially at any time and is a one-way form of communication.

Objectives

To identify potential risk areas and downfalls in the current referral system to the haematology department from other hospital inpatient specialties; and from this audit, to develop a standard for safe patient referral system, and implement this standard.

Methods

Current risk factors associated with the pager referral system were identified via a questionnaire given to all haematology doctors (n=10). To confirm the questionnaire reliability a Cronbach's alpha was calculated and determined as 0.77. Following this, a tailored solution addressing these issues was developed and implemented, consisting of an online platform where referrals can be received, documented and subsequent advice delivered. The new system was tailored to target these pitfalls by allowing for more efficient access of important information and greater traceability. In addition, guidance was delivered to other departments on how to use this new system. The new system was compared with the previous using the same questionnaire 1 month later.

Results

Many problems with the current referral procedure were identified including inability to document discussions, poor quality of note taking and wasting of clinicians’ time. The findings suggested that an online referral platform would improve patient care by reducing the inefficiency and unreliability of the current process. When asked on a scale of 1–10, how much do you think shifting to an online referral platform will improve patient care and quality of referrals, 100% of respondents answered 10.

Conclusion

Referral practice is an important process with patients often presenting with multiple health conditions requiring the attention of multiple specialties. It therefore needs to be well-documented and traceable. Implementation of an online referral system enables timely documentation and improves patient care.

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