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Referral patterns: an audit into referral practice among doctors in emergency medicine

The Lister Hospital, Stevenage, UK

Correspondence to:
Correspondence to:
C Reid
The Lister Hospital, Stevenage, SG1 4AB, UK; cilla.reid{at}nhs.net

Objectives: To develop a standard for safe patient referral from emergency medicine (EM) staff to hospital inpatient specialities; to audit adherence to that standard, and from this audit, to identify potential risk areas in this aspect of patient care; to make recommendations for reducing such risks; and to implement those recommendations.

Method: A standard was introduced and practice was compared to that standard using a telephone questionnaire.

Results: Many problems arising at referral were identified. From these, recommendations were made for improvements. At the base hospital, those recommendations were implemented. These potential pitfalls are highlighted, together with strategies for improving safe handover of patient care. The discussion includes a review of the literature on safe handovers, which underpins both the importance of this subject and our findings and recommendations.

Conclusions: Referral is an important skill for many doctors, particularly those in EM. It requires teaching and practice. The corollary to this is that education in this arena is also essential for those receiving referrals, to ensure smooth communication and safe systems of handover for patients.

Abbreviations: ED, emergency department; EM, emergency medicine; PRHO, pre-registration house officer; SG, staff grade; SHO, senior house officer; SpR, specialist registrar

Keywords: referrals; handover; risk

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