Title : En route to high quality respiratory referrals
Abstract:
Background: High-quality respiratory referrals are essential to ensure timely advice and treatment, ultimately improving patient care and outcomes. Currently, online referrals from other wards in the hospitals are sent daily to the respiratory department; however, the quality of these referrals is often poor. This is an area in need of significant improvement.
Aims: To design interventions to improve the quality of respiratory referrals, to provide better and faster patient care during hospitalisation at King George Hospital, London.
Methods: 6-sigma and PDSA methodology was utilized as a part of quality improvement project. Cases were sampled from the referral pool, sent from medical wards, acute assessment and intensive care units between December 2024 and January 2025. Outcome measures were listed as the date of admission, presenting complaint, smoking status, relevant respiratory diseases, medications, oxygen requirement if applicable, imaging and blood test results, current management plan and specific question to the respiratory team. Posters were placed for a targeted intervention to improve the quality of referrals to gather data for January – February 2025 period.
Conclusions: We received 75 referrals between December 2024 and January 2025 (pre-poster period), and 60 referrals between January and February 2025 (post-poster period). Following the introduction of educational posters in the hospital, there was a 12% increase in the documentation of presenting complaints on referral forms. Smoking status was documented in 56% of referrals post-intervention, compared to only 21% prior. Additionally, 88% of referrals included imaging details, and 65% included blood test results — representing a 27% and 23% improvement, respectively, compared to the pre-poster data. There was also a notable reduction in referrals lacking a clearly documented clinical question, decreasing from 14% to 1.6%.
