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Saeed H, Wallner PE, Bates JE, Chundury A, Freedman LM, Mitin T, Walker GV, Small W, Schechter NR. ACR-ARS Practice Parameter for Communication: Radiation Oncology. Am J Clin Oncol 2024; 47:210-216. [PMID: 38149838 DOI: 10.1097/coc.0000000000001078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
BACKGROUND This practice parameter was revised collaboratively by the American College of Radiology (ACR), and the American Radium Society (ARS). Timely, accurate, and effective communications are critical to quality and safety in contemporary medical practices. Radiation oncology incorporates the science and technology of complex, integrated treatment delivery and the art of providing care to individual patients. Through written physical and/or electronic reports and direct communication, radiation oncologists convey their knowledge and evaluation regarding patient care, clinical workup, and treatment provided to others in the management of the patient. Applicable practice parameters need to be revised periodically regarding medical record documentation for professional and technical components of services delivered. METHODS This practice parameter was developed and revised according to the process described under the heading "The Process for Developing ACR Practice Parameters and Technical Standards" on the ACR website ( https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards ) by the Committee on Practice Parameters-Radiation Oncology of the ACR Commission on Radiation Oncology in collaboration with the ARS. Both societies have reviewed and approved the document. RESULTS This practice parameter addresses radiation oncology communications in general, including (a) medical record, (b) electronic, and (c) doctor-patient communications, as well as specific documentation for radiation oncology reports such as (a) consultation, (b) clinical treatment management notes (including inpatient communication), (c) treatment (completion) summary, and (d) follow-up visits. CONCLUSIONS The radiation oncologist's participation in the multidisciplinary management of patients is reflected in timely, medically appropriate, and informative communication with patients, caregivers, referring physician, and other members of the health care team. The ACR-ARS Practice Parameter for Communication: Radiation Oncology is an educational tool designed to assist practitioners in providing appropriate communication regarding radiation oncology care for patients.
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Affiliation(s)
- Hina Saeed
- Lynn Cancer Institute Boca Raton, Baptist Health, Boca Raton
| | | | | | | | | | - Timur Mitin
- Oregon Health and Science University, Portland, OR
| | | | - William Small
- Department of Radiation Oncology, Maguire Center, Maywood
- Banner MD Anderson Cancer Center, Gilbert, AZ
| | - Naomi R Schechter
- South Florida Proton Therapy Institute, Delray Beach, FL
- Rakuten-Medical, San Diego, CA
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Fritz Z, Griffiths FE, Slowther AM. Custodians of Information: Patient and Physician Views on Sharing Medical Records in the Acute Care Setting. HEALTH COMMUNICATION 2021; 36:1879-1888. [PMID: 32814466 PMCID: PMC8601592 DOI: 10.1080/10410236.2020.1803553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In the UK, in the acute in-patient setting, the only information that a patient receives about their medical care is verbal; there is no routine patient access to any part of the medical record. It has been suggested that this should change, so that patients can have real-time access to their notes, but no one has previously explored patient or clinician views on the impact this might have. Semi-structured interviews were conducted with 12 patients and 13 doctors about their experience of information sharing in the context of the acute care setting, and their views on sharing all of the medical records, or a summary note. Interviews were transcribed verbatim, double coded and analyzed using the constant comparative method. Patients were not given written information and did not ask questions even when they wanted to know things. Patients and doctors supported increased sharing of written information, but the purpose of the medical record - and the risks and benefits of sharing it - were disputed. Concerns included disclosing uncertainty, changing what was written, and causing patient anxiety. Benefits included increased transparency. Use of a summary record was welcomed as a way to empower patients, while doctors felt they had a responsibility to curate what information was given and when. A clinical summary for patients would be of benefit to doctors, nurses, patients and their relatives. It should be designed to reflect the needs of all users, and evaluated to consider patient-relevant outcomes and resource implications.
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Affiliation(s)
- Zoe Fritz
- THIS (The Healthcare Improvement Studies) Institute, University of Cambridge
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Abstract
AIM/OBJECTIVES/BACKGROUND Timely, accurate, and effective communications are critical to quality in contemporary medical practices. Radiation oncology incorporates the science and technology of complex integrated radiation treatment delivery and the art of managing individual patients. Through written physical and/or electronic reports and direct communication, radiation oncologists convey critical information regarding patient care, services provided, and quality of care. Applicable practice parameters need to be revised periodically regarding medical record documentation for professional and technical components of services delivered. METHODS The ACR-ASTRO Practice Parameter for Communication: Radiation Oncology was revised according to the process described on the American College of Radiology (ACR) Web site ("The Process for Developing ACR Practice Parameters and Technical Standards," www.acr.org/ClinicalResources/Practice-Parametersand-Technical-Standards) by the Committee on Practice Parameters of the ACR Commission on Radiation Oncology in collaboration with the American Society for Radiation Oncology (ASTRO). Both societies then reviewed and approved the document. RESULTS This practice parameter addresses radiation oncology communications in general, including (a) medical record, (b) electronic, and (c) doctor-patient communications, as well as specific documentation for radiation oncology reports such as (a) consultation, (b) clinical treatment management notes (including inpatient communication), (c) treatment (completion) summary, and (d) follow-up visits. CONCLUSIONS The radiation oncologist's participation in the multidisciplinary management of patients is reflected in timely, medically appropriate, and informative communication with the referring physician and other members of the health care team. The ACR-ASTRO Practice Parameter for Communication: Radiation Oncology is an educational tool designed to assist practitioners in providing appropriate communication regarding radiation oncology care for patients.
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Amirav I, Vandall-Walker V, Rasiah J, Saunders L, Belur H, Sahlin B, Roduta Roberts M, Redlich-Amirav D. An Asthma Specialist's Consult Letter: What Do Parents Think About Receiving a Copy? J Asthma Allergy 2020; 13:179-186. [PMID: 32440163 PMCID: PMC7217314 DOI: 10.2147/jaa.s249893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/19/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Written summaries about visits with general practitioners' have influenced increased patient knowledge, satisfaction, recollection, and compliance, and strengthened the doctor-patient relationship. All previous studies about this communication pre-dated the electronic medical record (EMR) era, and none examined views from parents of children with asthma. We explored parents' perceptions about receiving a hard copy summary Letter immediately following the visit, with the pediatric asthma specialist about findings and the care plan for their child. METHODS A Parent Advisory Council helped inform this pilot study, an observational cross-sectional electronic survey. Each Letter included a comprehensive summary of the child's visit with the specialist. RESULTS Previous findings from patients about the benefits of receiving this Letter were strongly supported by data from 51 participants. Interestingly, more than 54% of respondents preferred receiving a hard copy Letter over an electronic copy, and 98% wanted other clinicians to adopt this practice. CONCLUSION Parents of children with asthma value and want timely written information of this nature from other clinicians. PRACTICE IMPLICATIONS These results can influence further asthma research to promote a change in the perceptions of clinicians, parents, and patients about timely access to health information in the EMR era.
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Affiliation(s)
- Israel Amirav
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Virginia Vandall-Walker
- Patient Engagement Platform, Alberta SPOR Support Unit, Edmonton, Alberta, Canada
- Faculty of Health Disciplines, Athabasca University, Athabasca & Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Jananee Rasiah
- Patient Engagement Platform, Alberta SPOR Support Unit, Edmonton, Alberta, Canada
- Faculty of Health Disciplines, Athabasca University, Athabasca & Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | | | - Harsha Belur
- Parent Advisory Council, Edmonton, Alberta, Canada
| | | | - Mary Roduta Roberts
- Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Dorit Redlich-Amirav
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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Hoffmann M, Schwarz CM, Pregartner G, Weinrauch M, Jantscher L, Kamolz L, Brunner G, Sendlhofer G. Attitudes of physicians towards target groups and content of the discharge summary: a cross-sectional analysis in Styria, Austria. BMJ Open 2019; 9:e034857. [PMID: 31852713 PMCID: PMC6937118 DOI: 10.1136/bmjopen-2019-034857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The discharge summary (DS) represents one of the most important instruments to ensure a safe patient discharge from the hospital. They sometimes have poor quality in content and often include medical jargon, which the patient and their relatives cannot easily understand. Therefore, many risks for patient safety exist. This study investigated the questions for whom the DS is and which contents are necessary to ensure a safe treatment. DESIGN Cross-sectional analysis. SETTING Styria, Austria. PARTICIPANTS 3948 internal and external physicians were consulted. INTERVENTIONS An online survey consisting of 24 questions was conducted. The survey was distributed to physicians working in the province of Styria, Austria, in 2018 over a period of 6 months. MAIN OUTCOMES AND MEASURES Attitudes of internal and external physicians in terms of target group, content and health literacy. RESULTS In total, 1060 physicians participated in the survey. The DS is considered as a communication tool among physicians (97.9%) and the patients are also indicated as addressees (73.5%). Furthermore, there is a high level of agreement that understandable information in the DS leads to fewer questions of the patients (67.9%). CONCLUSION In conclusion, the DS is not only seen as a document for the further treating physician but is also relevant for the patient. Incorporating the patient into their treatment at all levels may possibly strengthen the individual health literacy of the patient and their caring relatives.
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Affiliation(s)
- Magdalena Hoffmann
- Executive Department for Quality and Risk Management, Hospital of the Federal State of Styria and University Hospital Graz, Graz, Austria
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Christine Maria Schwarz
- Executive Department for Quality and Risk Management, Hospital of the Federal State of Styria and University Hospital Graz, Graz, Austria
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics und Documentation, Medical University of Graz, Graz, Austria
| | - Maximilian Weinrauch
- Executive Department for Quality and Risk Management, Hospital of the Federal State of Styria and University Hospital Graz, Graz, Austria
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Lydia Jantscher
- Executive Department for Quality and Risk Management, Hospital of the Federal State of Styria and University Hospital Graz, Graz, Austria
| | - Lars Kamolz
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Gernot Brunner
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Gerald Sendlhofer
- Executive Department for Quality and Risk Management, Hospital of the Federal State of Styria and University Hospital Graz, Graz, Austria
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
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Zimmermann C, Meurer MI, Lacerda JTD, Mello ALSFD, Grando LJ. The use of tools to support oral lesion description in oral medicine referrals. Braz Oral Res 2017; 31:e93. [DOI: 10.1590/1807-3107bor-2017.vol31.0093] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/28/2017] [Indexed: 11/22/2022] Open
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From the laboratory to the clinic: sharing BRCA VUS reclassification tools with practicing genetics professionals. J Community Genet 2017; 9:209-215. [PMID: 29124491 DOI: 10.1007/s12687-017-0343-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 10/19/2017] [Indexed: 10/18/2022] Open
Abstract
Despite ongoing research efforts to reclassify BRCA variant of uncertain significance (VUS), results for strategies to disseminate findings to genetic counselors are lacking. We disseminated results from a study on reclassification of BRCA VUS using a mailed reclassification packet including a reclassification guide, patient education aid, and patient letter template for patients/families with BRCA VUS. This study reports on genetic counselors' responses to the dissemination materials. Eligible participants (n = 1015) were identified using mailing lists from professional genetics organizations. Participants were mailed a BRCA VUS reclassification packet and a return postcard to assess responses to the materials. Closed-ended responses were analyzed using descriptive statistics, and thematic analysis was conducted on open-ended responses. In response to the mailing, 128 (13.0%) genetic counselors completed and returned postcards. The majority of respondents (n = 117; 91.4%) requested the patient letter template and patient education guides as PDFs (n = 122; 95.3%). The majority (n = 123; 96.9%) wanted an updated reclassification guide upon availability. Open-ended responses demonstrate the material was well-received; some specified they would tailor the patient letter to fit their practice and patients' needs. Participants requested additional patient and provider educational materials for use in practice. Materials communicating BRCA VUS reclassification updates were liked and were likely to be used in practice. To achieve the benefits of VUS reclassification in clinical practice, ongoing efforts are needed to continuously and effectively disseminate findings to providers and patients.
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Fenton C, Al-Ani A, Trinh A, Srinivasan A, Marion K, Hebbard G. Impact of providing patients with copies of their medical correspondence: a randomised controlled study. Intern Med J 2017; 47:68-75. [PMID: 27616436 DOI: 10.1111/imj.13252] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/01/2016] [Accepted: 09/05/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND In Australia, correspondence is routinely sent to general practitioners following a specialist consultation. Written communication is an important way to enhance patient experiences and understanding, yet most patients do not receive copies of their medical correspondence. AIMS To determine whether providing clinic correspondence and endoscopy reports to patients leads to improved understanding, satisfaction or anxiety. METHODS This is a prospective, randomised controlled study conducted at an Australian tertiary hospital from October 2013 to February 2015. New adult referrals to the general gastroenterology clinic requiring an urgent endoscopic procedure were eligible for the study. The intervention group received a copy of their clinic correspondence and endoscopy report, while the control group received neither. Participants completed questionnaires, including visual analogue scales and the Hospital Anxiety and Depression Scale, at three time points. Primary outcomes were patient understanding, anxiety and satisfaction. RESULTS A total of 70 participants was included in the study. There was no reduction in anxiety levels (P = 0.52), no increase in understanding (P = 0.73) or any increase in satisfaction (P = 0.33) in participants receiving correspondence. However, 97% of participants indicated that they wished to receive correspondence in the future, and 94% of participants in the correspondence group reported that receiving correspondence had helped them to understand their medical condition. CONCLUSION Patients wish to receive copies of their correspondence and feel it improves their understanding of their medical condition. Although we were unable to demonstrate a measurable reduction in anxiety, increase in understanding or satisfaction, we recommend that patients be offered the choice of receiving copies of their clinic correspondence and endoscopy reports.
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Affiliation(s)
- C Fenton
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Al-Ani
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Trinh
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - A Srinivasan
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - K Marion
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - G Hebbard
- Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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Perrot S, Launay A, Desjeux D, Cedraschi C. Pain patients' letters: The visit before the visit - A qualitative analysis of letters from patients referred to a tertiary pain center. Eur J Pain 2017; 21:1020-1030. [PMID: 28169480 DOI: 10.1002/ejp.1004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2016] [Indexed: 11/12/2022]
Abstract
BACKGROUND Pain centers manage only selected patients, and have long waiting lists. Some patients spontaneously send letters, before the visit, and these letters represent the first contact between the patients and the pain centers. We report a study of the content and format of these letters, for a patient perspective analysis. METHODS During a 3 month-period, all newly referred patients to a tertiary pain center were considered. If a patient letter was provided, it was collected for analysis. Qualitative analyses including semantic and content analyses were performed to identify themes and categories. RESULTS Among 138 newly referred patients, 44 had sent a letter before consultation. Content analysis of 42 letters disclosed four themes: I) pain experience; II) impact of the pain problem; III) patient history; and IV) expectations. These themes could be distributed along four pain dimensions: (1) physical; (2) psycho-affective; (3) social; and (4) temporal. This first study on patient letters reveals that a bio-psychosocial model. Patients contribute actively to their trajectory, not only as healthcare seekers but also by constructing their narrative identity. CONCLUSIONS Patient letters constitute narrative material to be integrated into clinical analysis, alongside patient interviews, especially in pain management. Pain specialists should take account of this narrative approach to better understand the unvoiced and sometimes silent experience of pain. This may increase quality of medical care by including patient-centered data in an original method. Further studies may be valuable to analyze the possible contributions of such letters to patient management. SIGNIFICANCE Patients' letters constitute original narrative material to be integrated into clinical analysis, especially for pain management. Patients' letters analyses may improve the patient physician relationship, by understanding patient's perspectives, beliefs and expectations.
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Affiliation(s)
- S Perrot
- Pain Center, Cochin Hotel-Dieu Hospital, INSERM U 987, Paris Descartes University, Paris, France
| | - A Launay
- Pain Center, Cochin Hotel-Dieu Hospital, INSERM U 987, Paris Descartes University, Paris, France
| | - D Desjeux
- Department of Anthropology and Education, Paris Descartes University, Paris, France
| | - C Cedraschi
- Pain Center, Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.,Division of General Medical Rehabilitation, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
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Assessment of the Readability of Genetic Counseling Patient Letters. J Genet Couns 2015; 25:454-60. [DOI: 10.1007/s10897-015-9890-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 09/16/2015] [Indexed: 10/23/2022]
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Cachat F, Marques-Vidal P, Girardin E, Chehade H, Piot-Ziegler C. Parents and primary care physicians have different views about copying medical letters to parents after paediatric outpatient visits. Acta Paediatr 2014; 103:e459-64. [PMID: 24953484 DOI: 10.1111/apa.12725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 04/11/2014] [Accepted: 06/17/2014] [Indexed: 11/30/2022]
Abstract
AIM We assessed how satisfied parents were when they received a copy of the letter sent to their primary care physician after their child attended a hospital outpatient clinic and compared their views with those of the primary care physician. METHODS Anonymised questionnaires were sent to parents, and their primary care physician, after their child had visited a paediatric nephrology unit. RESULTS We received responses from 112 parents (46%) and 69 primary care physicians (93%). Most parents (97%) were satisfied with the process, 94% thought that the letter was a true reflection of the outpatient consultation and easy to understand, and 55% read it to their child. However, 21% would have preferred a simpler letter. More than a third (37%) of the primary care physicians did not approve of the parents being sent the letter, and 30% felt that the letter was difficult for the parents to understand and should be replaced with a simpler letter. CONCLUSION Most parents (97%) appreciated receiving a copy of the letter following their child's outpatient clinic visit, and 95% understood its contents. More than half (55%) read the letter to their child. However, 37% of primary care physicians did not approve of the practice.
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Affiliation(s)
- Francois Cachat
- Division of Paediatric Nephrology; Department of Paediatrics; University Hospital; Lausanne Switzerland
| | - Pedro Marques-Vidal
- Division of Biostatistics; Institute of Social and Preventive Medicine; University Hospital of Lausanne; Lausanne Switzerland
| | - Eric Girardin
- Division of Paediatric Nephrology; Department of Paediatrics; University Hospital; Geneva Switzerland
| | - Hassib Chehade
- Division of Paediatric Nephrology; Department of Paediatrics; University Hospital; Lausanne Switzerland
| | - Chantal Piot-Ziegler
- Department of Psychology, Health Psychology; University of Lausanne; Lausanne Switzerland
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Western CE, Faux JW. Patient correspondence after outpatient appointments: what format should it take? PATIENT EDUCATION AND COUNSELING 2011; 83:283-284. [PMID: 20619575 DOI: 10.1016/j.pec.2010.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2010] [Revised: 05/18/2010] [Accepted: 05/30/2010] [Indexed: 05/29/2023]
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Abstract
SummaryProviding information to older adults is essential for informed decision-making and good health. Because there are significant deficits in providing information verbally, health professionals must use written information as well. Most studies have focused on the content and literacy of documents. However, the legibility and formatting are critically important for older adults, who are more likely to suffer with visual impairment. Providing written information that is tested for appropriate reading level and for presentation is necessary to ensure that older adults can use the information given. There are a number of tools available that test these aspects of written information, but not one tool that is universally accepted. Further research regarding the design and presentation of written information for older adults is necessary.
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A survey of patient views on receiving vascular outpatient letters. Eur J Vasc Endovasc Surg 2010; 39:5-10. [PMID: 19836276 DOI: 10.1016/j.ejvs.2009.09.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Accepted: 09/22/2009] [Indexed: 11/20/2022]
Abstract
AIM To assess the attitude of patients to receiving a copy of vascular outpatient clinic letters. METHOD 100 patients attending an outpatient vascular clinic at Christchurch Hospital were sent a copy of their outpatient letter along with a questionnaire. This gathered information on the content of the letter, their understanding of it, how useful they found it and whether they would want this practice to continue. RESULTS The response rate was 68%. Ninety four percent of the responders believed receiving a copy of the letter was a good reinforcement of the information they received at the consultation. Ninety three percent of responders also found being copied into correspondence helpful and 96% understood the contents of the letters. Ninety seven percent wished to receive more letters in the future. CONCLUSION These results suggest that vascular surgery patients both value and understand clinic letters, and that health professionals should consider adopting this practice into their vascular outpatient clinics.
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Ireson CL, Slavova S, Steltenkamp CL, Scutchfield FD. Bridging the care continuum: patient information needs for specialist referrals. BMC Health Serv Res 2009; 9:163. [PMID: 19754957 PMCID: PMC2759928 DOI: 10.1186/1472-6963-9-163] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 09/15/2009] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Information transfer is critical in the primary care to specialist referral process and has been examined extensively in the US and other countries, yet there has been little attention to the patient's perspective of the information transfer process. This cross-sectional study examined the quality of the information received by patients with a chronic condition from the referring and specialist physician in the specialist referral process and the relationship of the quality of information received to trust in the physicians. METHODS Structured telephone interviews were conducted with a random sample of 250 patients who had experienced a referral to a specialist for the first visit for a chronic condition within the prior six months. The sample was selected from the patients who visited specialist physicians at any of the 500 hospitals from the National Research Corporation client base. RESULTS Most patients (85%) received a good explanation about the reason for the specialist visit from the referring physician yet 26% felt unprepared about what to expect. Trust in the referring physician was highly associated with the preparatory information patients received. Specialists gave good explanations about diagnosis and treatment, but 26% of patients got no information about follow-up. Trust in the specialist correlated highly with good explanations of diagnosis, treatment, and self-management. CONCLUSION Preparatory information from referring physicians influences the quality of the referral process, the subsequent coordination of care, and trust in the physician. Changes in the health care system can improve the information transfer process and improve coordination of care for patients.
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Affiliation(s)
- Carol L Ireson
- College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - Svetla Slavova
- Office of Institutional Research, University of Kentucky, Lexington, Kentucky, USA
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Baxter S, Farrell K, Brown C, Clarke J, Davies H. Where have all the copy letters gone? A review of current practice in professional-patient correspondence. PATIENT EDUCATION AND COUNSELING 2008; 71:259-264. [PMID: 18222056 DOI: 10.1016/j.pec.2007.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 12/06/2007] [Accepted: 12/10/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This article reviews the literature in relation to patients receiving copies of health professional correspondence. It examines progress in adopting the practice 3 years on from its introduction as policy in the UK, and considers potential benefits and obstacles to implementation. METHODS A review of the literature on copy correspondence, accessed via Medline, PubMed, CINAHL and also online resources, using the search terms "patient letter", "copy letter", "copy correspondence" and "doctor letter". RESULTS Studies describe a range of benefits from copying letters, but implementation remains inconsistent, ranging from 8 to 87% of patients reporting receiving copy correspondence. A number of concerns are identified which may be delaying whole scale adoption of the policy by health professionals. CONCLUSION This review suggests that researchers should move from examining the benefits and concerns around copying letters to patients, and instead focus on exploring the quality of correspondence and the optimum process of implementing the practice. As patients can "opt out" of receiving copy correspondence, audit of service delivery may be better assessed by whether patients have been offered a letter, rather than the current measure of whether one has been received. PRACTICE IMPLICATIONS Copying letters to patients may have a number of important benefits and should be routine practice where patients wish to receive correspondence. Further discussion regarding the style and content of letters would be beneficial, together with attention paid to the mechanisms for recording patient preference. There is also a need for studies in non-medical professions.
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Affiliation(s)
- Susan Baxter
- Academic Unit of Child Health, PGME, Stephenson Unit, University of Sheffield, Western Bank, Sheffield S10 2TH, UK.
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Pothier DD, Nakivell P, Hall CEJ. What do patients think about being copied into their GP letters? Ann R Coll Surg Engl 2007; 89:718-21. [PMID: 17959014 DOI: 10.1308/003588407x205413] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Sending patients a copy of the letters that are produced for their referring general practitioners (GPs) from an out-patient consultation is a policy of the UK Department of Health. Little research has been done to establish how patients attending out-patient departments feel about this practice and the effect this may have on the department itself. PATIENTS AND METHODS We asked 500 patients attending our out-patient department to complete a questionnaire. Patients were only included if they had previously been offered a copy letter by our department. RESULTS Of patients, 95% were in favour of the practice and 93.4% understood all or most of the contents of the letter. Dictation in front of the patients made them less likely to request a copy of the letter (P < 0.001). Impact of queries related to the letters was minimal with only three patients making contact with the department during the 3 months that the study was being conducted. CONCLUSIONS Our experience has shown that copying patients into their GP letters is a useful and popular practice for patients and has little impact on the running of the department. Patients also are in favour of having their letter dictated in their presence and this reduces their need to have a copy sent to them.
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Affiliation(s)
- David D Pothier
- Department of Otolaryngology, Royal United Hospital, Bath, UK.
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