Junior doctor-led quality improvement project to improve safety and visibility of an interspecialty referral system

Interspecialty referrals for increasingly complex hospital inpatients are common and miscommunication often leads to delays in patient care. In a district general hospital, a web-based system generated an email referral, which lacked visibility and tracking/audit of the process, with no record gener...

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Bibliographic Details
Published in:BMJ open quality 2021-07, Vol.10 (3), p.e001323
Main Authors: Kwon, Dowan, Moon, Won Young, Akhunbay-Fudge, Michelle, Pieters, Brandon, Pillai, Jeni, Wilson, Charlie, Morrison, Jo
Format: Article
Language:English
Subjects:
Communication
Electronic health records
Health administration
Hospitals
Inpatient care
Length of stay
Medical referrals
Oncology
Patient safety
Physicians
Population
Quality control
Quality improvement
Quality Improvement Report
Teams
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Summary:Interspecialty referrals for increasingly complex hospital inpatients are common and miscommunication often leads to delays in patient care. In a district general hospital, a web-based system generated an email referral, which lacked visibility and tracking/audit of the process, with no record generated automatically in paper inpatient notes or electronic patient records (EPR). We aimed to improve the visibility and safety of the interspecialty referral system.We canvassed stakeholders, informally and via an online satisfaction survey, collecting qualitative and quantitative data about attitudes to the existing system, generating ideas for change. We process mapped the system, identifying points of weakness. We adapted our EPR system, using a work-around solution, to develop a form that could be emailed from the EPR. This generated a permanent record within the EPR and an electronic record of the referral having been sent. We measured the visibility of referrals and responses within the EPR. We generated an online training ‘how-to’ video and reaudited stakeholder satisfaction.There was a significant increase in the proportion of junior doctors satisfied or very satisfied with the interspecialty referral system (27/31 postintervention; 87.1% vs 26/55 preintervention; 47%; p
ISSN:2399-6641
2399-6641
DOI:10.1136/bmjoq-2020-001323