Research Network on Integrated Health Care in Western Norway, Helse Fonna HF, Valen Hospital, N-5451, Haugesund, Valen, Norway.
BMC Health Serv Res. 2013 Aug 19;13:329. doi: 10.1186/1472-6963-13-329.
In most Western countries, the referral letter forms the basis for establishing the priority of patients for specialised health care and for the coordination of care between the services. To be able to define the quality of referral letters, the potential impact of the quality on the organisation of care, and to improve the quality of the letters, we need a multidimensional definition of the ideal content. The study's aim was to explore what information is seen as most important and should be included in referral letters from primary care to specialised mental health care to facilitate prioritisation and planning of treatment and follow-up of the patients.
Based on purposive sampling, four mixed discussion groups, which included general practitioners, mental health nurses from primary health care, psychiatrists and psychologists from specialised mental health care, managers and patient representatives, were formed; they were asked to identify the information they considered important in a mental health referral letter. In line with the Delphi technique, the importance of the themes was later individually rated by the participants. The study was conducted within The Western Norway Regional Health Authority.
The four groups identified 174 information themes. After excluding themes that were assessed as duplicates, replaceable or less important, 40 themes were suggested, organised in seven units. A set of check-off points of essential information is recommended as an introduction in the referral letter.
Compared with general guidelines and guidelines for somatic care, the results of this study suggest that the referral letter to specialised mental health care should have a larger emphasis on the overall treatment plan, on the specific role of specialised health care in the continuum of care, and on patient involvement. Further research should evaluate the validity of these findings for other patient groups in need of integrated care and investigate how the quality of referral letters affects patient-related and organisational outcomes.
NCT01374035.
在大多数西方国家，转诊信是确定患者接受专科医疗保健的优先级和协调服务之间的护理的基础。为了能够定义转诊信的质量、质量对护理组织的潜在影响，并提高信件的质量，我们需要对理想内容进行多维定义。本研究旨在探讨从初级保健到专科精神卫生保健的转诊信中应包含哪些被认为是最重要的信息，以促进患者的优先排序和治疗计划，并对其进行随访。
基于目的抽样，成立了四个混合讨论小组，包括全科医生、初级保健的精神科护士、专科精神卫生保健的精神科医生和心理学家、管理人员和患者代表；他们被要求确定他们认为在精神科转诊信中重要的信息。根据德尔菲技术，后来由参与者单独对主题的重要性进行评分。该研究在西挪威地区卫生局进行。
四个小组确定了 174 个信息主题。在排除被评估为重复、可替代或不太重要的主题后，建议了 40 个主题，并将其组织成七个单元。建议在转诊信中引入一套必不可少的信息核对点。
与一般指南和躯体护理指南相比，本研究结果表明，专科精神卫生保健的转诊信应更加注重整体治疗计划、专科卫生保健在护理连续体中的具体作用以及患者的参与。进一步的研究应评估这些发现对于需要综合护理的其他患者群体的有效性，并调查转诊信的质量如何影响患者相关和组织结果。
NCT01374035。
