Department of Otorhinolaryngology-Head and Neck Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828.
Singapore Med J. 2010 Oct;51(10):796-9.
Communication between medical specialists and primary care providers in the community plays a pertinent role in patient care and doctor education. Referral and reply letters are the most common means by which doctors exchange information. Much of clinician time is spent writing letters, but the information or the format in which the letter is written may not meet the needs of the recipient. This study aimed to determine the type of reply letter preferred by general practitioners (GPs) and as such, attempts to improve communication between doctors as part of a quality assurance survey.
Questionnaires were mailed out to 1,700 GPs in Singapore. Each questionnaire was accompanied by two sample reply letters from the Department of Otorhinolaryngology-Head and Neck Surgery. The sample letters were written in different formats. Letter 1 was written in a non-structured, free text format and Letter 2 included a structured summary at the beginning. Both letters contained the same amount of information and the same number of words.
A total of 535 replies (response rate 32 percent) were received. Letter 2 was preferred in 97 percent of the responses. 96 percent of the doctors found Letter 2 to be easier to read, while 86 percent felt it contained more information and 64 percent felt that Letter 1 took a longer time to read.
Our study shows that there is a preference for diagnosis and treatment plan to be presented in a summary style report rather than as free text. A structured format for reply letters, including the use of headings, allows readers to easily identify the information desired and thus improves the quality of correspondence between specialists and GPs.
医学专家与社区初级保健提供者之间的沟通在患者护理和医生教育方面发挥着重要作用。转诊和回复信是医生交流信息最常用的方式。医生大部分时间都花在写信上,但信件中的信息或格式可能不符合收件人的需求。本研究旨在确定全科医生(GP)更喜欢哪种回复信,因此,作为质量保证调查的一部分,试图改善医生之间的沟通。
向新加坡的 1700 名全科医生邮寄了问卷。每个问卷都附有耳鼻喉头颈外科的两封示例回复信。示例信件采用不同的格式。信 1 采用非结构化的自由文本格式,信 2 开头包含结构化摘要。两封信包含相同数量的信息和相同数量的单词。
共收到 535 份回复(回复率为 32%)。97%的回复者更喜欢信 2。96%的医生认为信 2 更容易阅读,而 86%的医生认为信 2 包含更多信息,64%的医生认为信 1 需要更长的时间阅读。
我们的研究表明,人们更倾向于以总结性报告的形式呈现诊断和治疗计划,而不是自由文本。回复信的结构化格式,包括使用标题,可以让读者轻松识别所需信息,从而提高专家和全科医生之间往来信件的质量。