Practical Health Co-operation - a Randomised Controlled Intervention Study. The Impact of a Referral Template on Quality of Care and Health Care Co-operation Between Primary and Secondary Care
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 500
- 试验地点
- 2
- 主要终点
- Collated quality indicator score
研究概览
简要总结
The purpose of this study is to examine whether the implementation of a referral template will increase quality of health care delivered and the quality of health care co-operation. The investigators intent to implement a referral template, at the level of the general practitioner (GP), for the referral of patients within 4 separate diagnostic groups:
- dyspepsia/upper GI symptoms
- colonic cancer investigation/lower GI symptoms
- chronic obstructive pulmonary disease (COPD)
- chest pain
Local GP clinics will be randomised to use the referral template or to use standard referral practice. Using a predefined set of quality criteria the investigators will score the process of care in each patient, and compare intervention and control groups. In addition other criteria will be collected and compared between the two groups, e.g.
- time to diagnosis/treatment
- quality of referral
- more appropriate referrals
- patient satisfaction (as measured by a questionnaire)
The investigators hypothesize that the implementation of a referral template will lead to a measurable increase in the quality of health care delivered.
详细描述
There is a continuous work to improve the quality of health care delivered to an individual patient, both in primary and secondary care. The referral from primary to secondary care represents a key component in the communication between the levels of care, and therefore an important tool in developing the quality of care. There has been many attempts at improving the quality of referrals, but less work has been focussed on the consequence of such improvement on quality of health care. This study is designed as a randomised controlled intervention study where we intent to implement a referral templates, at the level of the general practitioner (GP). These templates will be for the referral of patients within 4 separate diagnostic groups:
- dyspepsia/upper GI symptoms
- colonic cancer investigation/lower GI symptoms
- chronic obstructive pulmonary disease (COPD)
- chest pain
Following the course of the health care process we will assess the quality of the care process by using predefined quality of care criteria, together with patient satisfaction (as measured by questionnaire) and other health process indicators.
Our primary hypothesis is that the implementation of a referral template in the communication between primary and secondary care, will lead to a measurable increase in the quality of health care delivered.
Secondary hypothesis include:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •referral to medical department of University Hospital of North Norway, Harstad
排除标准
- •children (< 18 years of age)
- •patients with reduced capacity to consent
结局指标
主要结局
Collated quality indicator score
时间窗: The care period for each patient (approx. 3 weeks up to 1 year)
Based on treatment guidelines and international quality assessment tools we have developed quality indicators score sets for each of the 4 diagnostic groups in the study. The scores will be compared between intervention and control GP offices to assess the effect of the referral template.
次要结局
- Percentage of patients seen within investigation deadline(Assessed at end of study - approx 2 years)
- Improved referral quality(The care period for each patient (approx. 3 weeks up to 1 year))
- Number of patients designated with investigation deadline(Assessed at end of study - approx 2 years)
- Number of appointments needed for diagnostic clarification(The care period for each patient (approx. 3 weeks up to 1 year))
- Patient satisfaction(The care period for each patient (approx. 3 weeks up to 1 year))
- Time from referral to initiation of treatment(The care period for each patient (approx. 3 weeks up to 1 year))
- Waiting time from referral to appointment(The care period for each patient (approx. 3 weeks up to 1 year))
- Positive predictive value of referral(The care period for each patient (approx. 3 weeks up to 1 year))