Development and validation of a tool to improve paediatric referral/consultation communication

• Published in: BMJ quality & safety Vol. 20; no. 8; pp. 692 - 697
• Main Authors: Stille, Christopher J, Mazor, Kathleen M, Meterko, Vanessa, Wasserman, Richard C
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.08.2011; BMJ Publishing Group LTD
• Subjects: Adolescent; Child; Child, Preschool; Communication; Diagnostic tests; Female; hand-off; Health administration; Humans; Interprofessional Relations; Male; medical home; Medicine - organization & administration; Patient safety; Pediatrics - organization & administration; Physicians; Primary care; Primary Health Care - organization & administration; Referral and consultation; Referral and Consultation - organization & administration; Reproducibility of Results; Studies
• ISSN: 2044-5415; 2044-5423
• DOI: 10.1136/bmjqs.2010.045781

ObjectiveTo develop a template to promote brief but high-quality communication between paediatric primary care clinicians and consulting specialists.MethodsThrough an iterative process with academic and community-based paediatric primary care providers and specialists, the authors identified what content elements would be of value when communicating around referrals. The authors then developed a one-page template to encourage both primary care and specialty clinicians to include these elements when communicating about referrals. Trained clinician reviewers examined a sample of 206 referrals from community primary care providers (PCPs) to specialists in five paediatric specialties at an academic medical centre, coding communication content and rating the overall value of the referral communication. The relationship between the value ratings and each content element was examined to determine which content elements contributed to perceived value.ResultsAlmost all content elements were associated with increased value as rated by clinician reviewers. The most valuable communications from PCP to specialist contained specific questions for the specialist and/or physical exam features, and the most valuable from specialist to PCP contained brief education for the PCP about the condition; all three elements were found in a minority of communications reviewed.ConclusionsA limited set of communication elements is suitable for a brief communication template in communication from paediatric PCPs to specialists. The use of such a template may add value to interphysician communication.