ANALYSIS OF REFERRING PROCESS FROM THE EMERGENCY DEPARTMENT TO GENERAL SURGERY

Abstract

Referring patients from the emergency department to specialty doctors is crucial but frustrating. This study identified discrepancy and common ground in the referring process between emergency doctors and general surgeons. A 32-day database of surgical referrals was analysed. Moreover, a ten-question survey was sent to both emergency and surgical doctors. Inappropriate referrals were 19%, with a peak of 50% in 24 hours. Appendicitis (23%) and small bowel obstruction (15%) were the commonest inappropriate diagnoses. The survey showed frustration was reported more by surgeons (P <.05), believing patients are not yet sufficiently assessed when referred (P <.05). A common consensus was found on the need for specific criteria to guide surgical referrals. Improvement of communication is recommended, especially with regard to the attitude used during referrals. Specialties’ relevance for specific conditions needs to be clarified. Eventually, a specific system is required to formally report inappropriate referrals and unprofessional behaviour.

Keywords

• referral
• communication
• diagnosis
• standards