苏格兰和英格兰社区验光师向医院眼科服务转诊的情况。
Referrals from community optometrists to the hospital eye service in Scotland and England.
机构信息
Centre for Applied Vision Research, City, University of London, London, UK.
Glasgow Caledonian University, Glasgow, UK.
出版信息
Eye (Lond). 2022 Sep;36(9):1754-1760. doi: 10.1038/s41433-021-01728-2. Epub 2021 Aug 6.
OBJECTIVES
This audit assesses communication between community optometrists (COs) and hospital eye service (HES) in Scotland and England.
METHODS
Optometric referrals and replies were extracted from six practices in Scotland and England. If no reply was found, replies/records were copied from HES records. De-identified referrals, replies and records were audited against established standards, evaluating whether referrals were necessary, accurate and directed to the appropriate professional. The referral rate (RR) and referral reply rate (RRR) were calculated.
RESULTS
From 905 de-identified referrals, RR ranged from 2.6 to 8.7%. From COs' perspective, the proportion of referrals for which they received replies ranged from 37 to 84% (Scotland) and 26 to 49% (England). A total of 88-96% of referrals (Scotland) and 63-76% (England) were seen in the HES. Adjusting for cases when it is reasonable to expect replies, RRR becomes 45-92% (Scotland) and 38-62% (England) with RRR significantly greater in Scotland (P = 0.015). Replies were copied to patients in 0-21% of cases. Referrals were to the appropriate service and judged necessary in ≥90% of cases in both jurisdictions. Accuracy of referral ranged from 89 to 97% (Scotland) and 81 to 98% (England). The reply addressed the reason for referral in 94-100% of cases (Scotland) and 93-97% (England) and was meaningful in 95-100% (Scotland) and 94-99% (England).
CONCLUSIONS
Despite the interdisciplinary joint statement on sharing patient information, this audit highlights variable standard of referrals and deficits in replies to the referring COs, with one exception in Scotland. Replies from HES to COs are important for patient care, benefitting patients and clinicians and minimising unnecessary HES appointments.
目的
本审计评估了苏格兰和英格兰的社区验光师（CO）与医院眼科服务（HES）之间的沟通情况。
方法
从苏格兰和英格兰的六家诊所中提取了验光转诊和回复。如果未找到回复，则从 HES 记录中复制回复/记录。对经过身份验证的转诊、回复和记录进行审核，以评估转诊是否必要、准确并指向合适的专业人员。计算转诊率（RR）和转诊回复率（RRR）。
结果
从 905 份经过身份验证的转诊中，RR 范围为 2.6 至 8.7%。从 CO 的角度来看，他们收到回复的转诊比例范围为 37%至 84%（苏格兰）和 26%至 49%（英格兰）。HES 共接诊了 88%至 96%（苏格兰）和 63%至 76%（英格兰）的转诊病例。在合理预期回复的情况下进行调整后，RRR 变为 45%至 92%（苏格兰）和 38%至 62%（英格兰），苏格兰的 RRR 明显更高（P=0.015）。在 0%至 21%的情况下，回复被复制给了患者。在两个司法管辖区中，转诊均针对适当的服务，且被判断为有必要的病例比例均≥90%。转诊的准确性范围为 89%至 97%（苏格兰）和 81%至 98%（英格兰）。在 94%至 100%的情况下（苏格兰）和 93%至 97%（英格兰），回复解决了转诊的原因，并且在 95%至 100%的情况下（苏格兰）和 94%至 99%（英格兰），回复具有意义。
结论
尽管有关于共享患者信息的跨学科联合声明，但本次审计突出了转诊标准的差异以及对转诊 CO 的回复不足，只有苏格兰有一个例外。HES 对 CO 的回复对于患者护理很重要，使患者和临床医生受益，并最大程度地减少不必要的 HES 预约。
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