SP9.7 A Quality Improvement Project to Optimise the Emergency Department to General Surgery Referral Process
Shifa Bangi, Charlotte Boardman, Ugochukwu Ihedioha- Surgery
Abstract
Introduction
Optimising the process of referrals from the Emergency Department (ED) can improve patient care. Currently, referrals to General Surgery (GS) are accepted by the Senior House Officer (SHO) and Registrar (SpR) on-call. This leads to two ongoing lists of referrals and the possibility of patients being missed. ED uses symphony to track referrals, but GS does not currently use this system.
Method
A survey was sent to all GS SHOs/SpRs to assess the process and tracking of referrals. Symphony was implemented as a virtual system to streamline the referral process. A repeat survey to evaluate the effectiveness of this intervention was conducted 1 month later.
Results
In the pre-intervention survey, 36% of doctors used a paper list to track referrals. The referral system was rated on average as 2.6/5 (1 – terrible, 5 - excellent). 50% reported feeling that patient safety had been compromised >5 times in the last month due to miscommunication between ED and GS. In the post-intervention survey, there was a significant decrease in the number of times patient safety was reported as being compromised in the last month (p=0.047). Pre-intervention, the theme of the majority of suggestions for improvement included an electronic system for tracking referrals, whereas post-intervention, most suggestions were about the history/ investigations done for each referral.
Conclusion
The use of the same system, symphony, by ED and GS has improved patient safety, although the Symphony program itself as well as the quality of referrals could be improved.