title: Does direct referral after an abnormal smear improve patient experience?
abstract: BACKGROUND
  Process-mapping of the patient pathway at the Birmingham Women's Hospital revealed that, after an abnormal smear was identified, women could experience a significant delay before referral for treatment. The direct referral policy was introduced in 2007 as part of a wider pan-Birmingham project to address this.
  
  
  OBJECTIVE
  To investigate the impact of the direct referral policy on patient experience.
  
  
  METHODS
  An integrated survey was conducted (n=200) and collected both quantitative and qualitative data. Following the introduction of a new information booklet, the same survey was repeated (n=200).
  
  
  RESULTS
  The findings showed that, although there was improvement in the information provided, some women stated that no information was received.
  
  
  CONCLUSIONS
  This highlights the fact that, while there is a need to repeat annual patient surveys to ensure the patient pathway is as robust as possible, surveys may not capture the quality of patients' clinical experience. Suggestions are made to address this (see Implications for practice).
  
  
  CONCLUSIONS
  This study shows the importance of evaluating any changes in care delivery. The direct referral policy has reduced the time it takes for women to be seen in the colposcopy department following an abnormal smear.
authors.affiliation: Birmingham Women's NHS Foundation Trust, Edgbaston, Birmingham.
authors.forename: Hilary
authors.initials: H
authors.lastname: Jefferies
authors.forename: Amanda
authors.initials: A
authors.lastname: Sutton
authors.forename: K K
authors.initials: KK
authors.lastname: Chan
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D003127:Colposcopy; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration; D008875:Middle Aged; D017060:Patient Satisfaction; D012017:Referral and Consultation; D013997:Time Factors; D006113:United Kingdom; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology*