[Quality improvement of referrals from practising physicians. An example of a practicable strategy].
BACKGROUND
Referrals from practising physicians to hospital departments are of varying quality. This increases the risk of inappropriate or even incorrect patient treatment courses. We examined the quality of referrals to a large department of nuclear medicine before and after initiatives aimed at improving the information and feedback to the practising physicians.


METHODS
An evaluation of the quality of referrals (n = 579) from praticising physicians to the Department of Nuclear Medicine, Odense University Hospital, Denmark, recorded during two periods of three months each before and after (1) publication of a referral guideline and (2) a feedback response to those physicians whose referrals were insufficient. A general practitioner (GP) and a specialist in nuclear medicine (NM) judged independently whether the referrals were good, acceptable or unacceptable.


RESULTS
During the two periods, 281 and 298 referrals were received, respectively. Of these, 37% and 27%, respectively, were from practising specialists (PSs). After intervention, 23% more referrals were received from GPs, and the share of "good" referrals also increased (before/after: 48%/72% (GP), 61%/84% (NM)). In contrast, there was a 23% decrease in referrals from PSs, whereas the share of "good" referrals remained unchanged or increased (before/after: 64%/66 % (GP), 64%/96% (NM)). In addition, there was a change in the referral pattern from both GPs and PSs.


CONCLUSIONS
Relatively simple and inexpensive intervention caused an increase in the number and quality of referrals from GPs and a fall in referrals from PSs without an obvious improvement in quality.
Grupe
Peter
P
Odense Universitets-hospital, Nuklearmedicinsk Afdeling, og Praksiskonsulentordningen i Fyns Amt, Odense C. peter.grupe@ouh.fyns-amt.dk
Grinsted
Per
P
Møldrup
Mette
M
Høilund-Carlsen
Poul F
PF
D003718:Denmark; D005194:Family Practice / Q000592:standards*; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D009683:Nuclear Medicine; D011785:Quality Assurance, Health Care; D012017:Referral and Consultation / Q000592:standards* / Q000706:statistics & numerical data