Structured Referral Form; Is it a solution for problems of referral communication in Sri Lanka

Abstract

INTRODUCTION: Referral letters convey information required for continuity of care when patients are referred to a hospital or a specialist. In Sri Lankan conventional, hand written letters are used for patient referrals and there is no standard format or a widely accepted guideline for referral communications. A structured referral form was designed to as a guide for the information to be included, as a solution to the problems in producing a good referral letter (time constrains, competence in language) and to prevent key problemsidentified in letters (omission of vital information, poor legibility and unsatisfactory format). This study was conducted to explore the acceptability, advantages and limitations of the structured referral form for GPs. METHODOLOGY: Referral form was designed based on the guidelines and literature reviews. 20 GPs were purposely selected to represent different backgrounds. Printed referral forms were provided to them and requested to use those for patient referrals for a period of 3 months. Telephone Interviews were conducted at the end of the study period to obtain their viewon the format. Themes expressed by participants were identified. RESULTS: It has improved the comprehensiveness of letters and saved time. Overall quality of letters has improved and participants were of the view that it could be used in any instance, competence in language was immaterial and retrieval of information would be easier. Inadequate space under a few subheadings was a limitation. There was no increase in reply letters after introducing this letter. They were willing to use that format in the future as well. Conclusions: This is a useful and acceptable tool to improve information transfer and it will also be a guide for doctors. It could be a solution to the problems of communication in patient referral in Sri Lanka