Department of General Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
Department of General Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Postgrad Med J. 2022 Jul;98(1161):e14. doi: 10.1136/postgradmedj-2020-139641. Epub 2021 Mar 31.
New requirements for hospital clinicians to follow up and act on hospital-initiated investigations were introduced in 2016 in the National Health Service standard contract. We aimed to evaluate the tasks handed over from hospital clinicians to general practitioners (GPs).
A retrospective observation of all tasks in a random sample of electronic discharge summaries at a university teaching hospital over a 1 month period was conducted. A single-best-answer questionnaire was circulated among hospital clinicians over 3 months to gain an understanding of their follow-up and referral practices.
The total number of tasks found on discharge summaries (n=178) were 227, of which 39% were directed at GPs and 61% at the hospital team. Of 89 tasks delegated to GPs, 33% were inappropriate. Some tasks on discharge summaries were delegated more frequently to GPs such as blood tests (73%) and endoscopy requests (67%). While others were undertaken more often by hospitals clinicians including imaging requests (88%), follow-up appointments (87%) and onward referrals (71%). Surveyed doctors (n=72) admitted to asking GPs to follow up blood tests (52%), imaging and endoscopy (16%) and make onward referrals for related conditions (14%) and unrelated conditions (70%).
The majority of outstanding tasks in the hospital setting were followed up by hospital clinicians. A considerable volume of tasks were delegated to GPs, of which a significant proportion were inappropriate. An increase in awareness and understanding among hospital clinicians of their responsibility to follow up hospital-initiated investigations is needed.
2016 年，国民保健制度标准合同对医院临床医生提出了新的要求，要求他们对医院发起的调查进行跟踪并采取行动。我们旨在评估从医院临床医生转移到全科医生（GP）的任务。
对大学教学医院在一个月内随机抽样的电子出院记录中的所有任务进行回顾性观察。在三个月内，向医院临床医生发放单项最佳答案问卷，以了解他们的随访和转诊实践。
出院记录上发现的任务总数（n=178）为 227，其中 39%针对 GP，61%针对医院团队。在委托给 GP 的 89 项任务中，33%是不恰当的。出院记录上的一些任务更多地委托给 GP，如血液检查（73%）和内窥镜请求（67%）。而其他任务则更多地由医院临床医生承担，包括影像请求（88%）、随访预约（87%）和转介（71%）。接受调查的医生（n=72）承认要求 GP 跟进血液检查（52%）、影像和内窥镜检查（16%），并为相关疾病（14%）和无关疾病（70%）进行转介。
医院环境中未完成的主要任务由医院临床医生跟进。相当一部分任务被委托给了 GP，其中相当一部分是不恰当的。医院临床医生需要提高对其跟进医院发起的调查的责任的认识和理解。
