[Problems in the transmission of information during within-hospital medical consultations and referrals].
OBJECTIVE
Within-hospital medical consultations and referrals (MCR) have many problems, among them are those related to the oral and written transmission of information. Our aim is to analyze problems in the transmission of information related to MCR, and possible differences between medical (MS) and surgical (SS) services.


METHODS
A prospective, observational study was conducted on the MCR requested to Internal Medicine Service over an 8 month period. The following variables were collected: age, sex, the requester, MCR type, type of admission, comorbidity, hospital stay and mortality, length of MCR, the number of physicians responsible for the patient requesting service during the MCR, MCR repeats, information on the request, available medical records, verbal contact, conflict between doctors, and medical information in the discharge summary.


RESULTS
Of the total 215 MCR received, 66 (30.7%) were requested by MS, and 149 (69.3%) per SS. MCR duration was 3 days (standard deviation [SD] 4.8. The number of doctors responsible was 1.7 (SD 1.1), with, Repeats 43 (20%) and Urgent 14 (6.5%). Minimum information on the request, 6 (9.1%) MS and 21 (27.5%) SS. Low availability of medical record, 2 (3%) MS and 50 (33.6%) SS. No verbal contact, 33 (15.4%). Conflict between doctors 13 (6%). Information acceptably good in MCR urgent request 100% MS, and 80% SS. Two out of three MCR were without reference to the discharge report.


CONCLUSIONS
There are significant losses in the transmission of information during the process of the MCR, which is higher in surgical than in medical departments.
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: eduardo.montero@salud.madrid.org.
E
E
Montero Ruiz
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
Á
Á
Rebollar Merino
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
V
V
Melgar Molero
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
J M
JM
Barbero Allende
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
A
A
Culebras López
Servicio de Medicina Interna, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España.
J
J
López Álvarez
D000368:Aged; D000369:Aged, 80 and over; D003144:Communication Barriers; D004630:Emergencies; D005260:Female; D006747:Hospital Communication Systems / Q000458:organization & administration*; D006748:Hospital Departments / Q000458:organization & administration*; D017052:Hospital Mortality; D006753:Hospital Records; D006760:Hospitalization; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008487:Medical History Taking; D008503:Medical Staff; D008875:Middle Aged; D010348:Patient Care Team; D011446:Prospective Studies; D012017:Referral and Consultation; D013030:Spain
Departamento de Cirugía; Hospital Surgery Department; Hospital communication systems; Inpatients; Internal Medicine; Medicina Interna; Pacientes ingresados; Referral and consultation; Remisión y consulta; Sistemas de comunicación hospitalarios