Assessing Referrals and Improving Information Availability for Consultations in an Academic Endocrinology Clinic
| Autor: | John N. Mecchella, Avin Pothuloori, Saumya Saini, Chase D. Hendrickson |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Referral Endocrinology Diabetes and Metabolism Specialty Information Dissemination MEDLINE Psychological intervention Guidelines as Topic 030209 endocrinology & metabolism Endocrine System Diseases Ambulatory Care Facilities Medical Records Workflow 03 medical and health sciences 0302 clinical medicine Endocrinology Ambulatory care Internal medicine Ambulatory Care medicine Electronic Health Records Humans New Hampshire 030212 general & internal medicine Referral and Consultation Academic Medical Centers business.industry Medical record General Medicine Guideline Quality Improvement Treatment Outcome Family medicine business |
| Zdroj: | Endocrine Practice. 23:190-198 |
| ISSN: | 1530-891X |
| DOI: | 10.4158/ep161514.or |
| Popis: | Outpatient specialty consultations rely on the timeliness and completeness of referral information to facilitate a valuable patient-specialist interaction. This project aimed to increase essential diagnostic information availability at the initial consultation for patients referred for common endocrine conditions frequently lacking such data-diabetes mellitus, thyroid nodule, thyrotoxicosis, and hypercalcemia.At an endocrinology clinic at an academic medical center in rural New England, providers see several thousand new patients annually, the majority of whom are referred by providers external to the clinic's healthcare system. Through consensus, endocrinology clinic providers agreed on the two or three data elements essential for a meaningful initial consultation for each. A quality improvement team employed a planned series of interventions based on previously published methods and an innovative approach: dissemination of a referral guideline, an assessment of referral adequacy in the endocrinology clinic workflow, coupled with focused requests for missing items, and a pre-visit lab appointment.Between April 2015 and March 2016, 762 referrals were reviewed. At baseline for the four conditions, referrals contained all essential elements only 27.5% (22 of 80) of the time. Over a 7-month period, the team implemented the interventions, with subsequent referrals containing all essential elements increasing to 75.5% (P.0001), largely attributable to the pre-visit lab appointment.Incoming referrals that lack essential information are a significant problem in specialty care and may adversely affect patient experience, provider satisfaction, and clinic efficiency. Improvement may require innovative approaches, such as the potentially transferable and generalizable ones employed here.DHMC = Dartmouth-Hitchcock Medical Center EHR = electronic health record PDSA = Plan-Do-Study-Act. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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