A training programme did not increase agreement between allied health clinicians prioritizing patients for community rehabilitation.

OBJECTIVE

To evaluate the effect of formal training on agreement between clinicians making decisions on client priority.

SETTING

A centralized intake service receiving referrals for a community rehabilitation programme.

DESIGN

Agreement was measured between the priority categories allocated to consecutive referrals by one of five clinicians in the referral office compared with a second rating made by an independent occupational therapist, blinded to the initial priority rating. Data collection followed the implementation of four 1-hour workshops involving all raters, designed to increase consistency of triage decisions. Results were compared to a previous study conducted prior to the training.

PARTICIPANTS

Two hundred and one consecutive referrals received for community rehabilitation services, triaged by experienced clinicians with allied health or nursing qualifications.

OUTCOME MEASURE

Agreement using weighted kappa (κ(w)).

RESULTS

There was no change in agreement between clinicians after training, compared with a previous study in the same setting. Agreement remained moderate (κ(w) = 0.50), with clinicians disagreeing on approximately 30% of referrals.

CONCLUSIONS

Three out of 10 clients will receive a different priority rating and waiting time for rehabilitation services depending on which clinician in the referral office made the rating. This result was not improved by conducting a training programme.