title: Closing the loop: feedback to accident and emergency SHOs on their referrals to hospital specialists.
abstract: OBJECTIVE
  To determine whether A&E SHOs in the Anglia and Oxford region receive regular case-specific feedback on their referrals to hospital specialists.
  
  
  METHODS
  A telephone survey of an A&E SHO from each hospital in the region, using a semi-structured questionnaire and written protocol. The main questions asked were: (i) do you receive regular feedback about specific patients you refer to other specialties? If so, which one(s)? and (ii) do you think personal regular case-specific feedback about your referrals would be useful?
  
  
  RESULTS
  Overall, 18 A&E SHOs and one staff grade were interviewed, one from each hospital (response rate 100%). Over the whole region, there were 106 hospital specialties to which A&E SHOs could directly refer out-patient cases. However, regular case-specific communication or feedback was received by the referring A&E SHO from only 5 (4.7%). There were 237 hospital specialties to which A&E SHOs could directly refer in-patients. However, regular case-specific feedback was received by the referring A&E SHO from only 3 specialities (1.3%). The A&E doctors at 18 of the 19 hospitals (95%) felt regular case-specific feedback would be useful. Of these, 13 (72%) would prefer written feedback - 5 (38%) would prefer a copy of the discharge summary or GP clinic letter, 6 (46%) a letter written specifically to the A&E SHO, 1 a letter to be sent via the A&E consultant, and 1 wished for 'any written feedback'. All 18 doctors wanted feedback from at least one of the specialties of general medicine, paediatrics, trauma and orthopaedics, and general surgery.
  
  
  CONCLUSIONS
  A&E SHOs in the Anglia and Oxford region do not receive regular case-specific feedback on their referrals to hospital specialists. Almost all A&E SHOs in this study would welcome it. The situation could be rectified by routinely sending them copies of clinic letters or discharge summaries.
authors.affiliation: Accident and Emergency Department, The Queen Elizabeth Hospital, Kings Lynn, Norfolk, UK.
authors.forename: R S K
authors.initials: RS
authors.lastname: Florance
authors.forename: N
authors.initials: N
authors.lastname: Garneti
authors.forename: N
authors.initials: N
authors.lastname: Burchett
mesh_terms: D000553:Ambulatory Care; D004636:Emergency Service, Hospital; D004739:England; D005246:Feedback; D006760:Hospitalization; D006801:Humans; D008505:Medical Staff, Hospital; D011364:Professional Practice; D012017:Referral and Consultation / Q000458:organization & administration* / Q000592:standards