Pediatric Opthalmology and Strabismus, Aravind Eye Hospital, Pondicherry, India.
Vitreo-Retina, Aravind Eye Hospital, Pondicherry, India.
Indian J Ophthalmol. 2022 Jan;70(1):223-227. doi: 10.4103/ijo.IJO_1446_21.
The study was aimed at finding out the present pattern of referrals to the Pediatric Ophthalmology outpatient department (OPD) in a tertiary eye care hospital and thus identify the discrepancy of referral, if any, which would help to modify and enhance the practice guidelines.
The study was conducted by retrospectively collecting data from all referral letters that were already uploaded in the Electronic Medical Report (EMR) against all patients from June 2019 to December 2019. All pediatric patients in the age group of 0-16 years were included in the study. The practicing field of referring clinicians was noted along with the maximum information that could be collected from the referral letter and were thus assessed for the quality, accuracy, and timely referral.
Out of 77 referrals received in the study period, six referral letters neither had any mention of the designation of the referring clinician nor any specific diagnosis or details. Thus, only 71 patients were included for further study. The referring clinicians were mainly ophthalmologists, pediatricians, general practitioners (GPs), and others (cardiologists, neurologists). Maximum patients were referred by ophthalmologists (76%) but visual acuity was noted only for 30% of these patients. Almost half of the referral diagnosis was accurate. Pediatrician referrals were found to be more detailed and précised.
There is a need for a standardized hospital-specific format of referrals and basic training to primary care providers on some simple tests (Lights reflex tests) for identifying the "red flags" in pediatric eye examination and thus enhancing the quality and timely referral per se.
本研究旨在了解三级眼科医院儿科眼科门诊(OPD)的转诊现状,从而发现转诊差异(如果有),以帮助修改和完善实践指南。
本研究通过回顾性收集 2019 年 6 月至 2019 年 12 月期间所有已上传至电子病历(EMR)的转诊信中的数据进行。研究纳入所有 0-16 岁的儿科患者。记录转诊临床医生的执业领域,以及从转诊信中尽可能收集到的最大信息,并据此评估其质量、准确性和及时转诊情况。
在研究期间收到的 77 份转诊中,有 6 份转诊信既没有提到转诊临床医生的职称,也没有任何具体的诊断或细节。因此,只有 71 名患者被纳入进一步研究。转诊医生主要是眼科医生、儿科医生、全科医生(GP)和其他医生(心脏病专家、神经科医生)。最大比例的患者由眼科医生转诊(76%),但只有 30%的患者记录了视力。近一半的转诊诊断是准确的。儿科医生的转诊被认为更详细和准确。
需要制定标准化的医院特定转诊格式,并对初级保健提供者进行一些简单测试(如光反射测试)的基本培训,以识别儿科眼部检查中的“红色信号”,从而提高质量和及时性。