Audit of acute referrals to the Department of Dermatology at Waikato Hospital: Comparison with national access criteria for first specialist appointment

Show simple item record Stanway, A Oakley, A Rademaker, M Duffill, M
dc.coverage.spatial New Zealand 2022-05-12T04:52:55Z 2022-05-12T04:52:55Z 2004-04-23
dc.identifier.citation (2004). New Zealand Medical Journal, 117(1192), U849-.
dc.identifier.issn 0028-8446
dc.description.abstract AIM: This audit was designed to compare current referral practice with the Ministry of Health elective services National Access Criteria for first Specialist Assessment (ACA) guidelines, to identify specific problems, and (if possible) to improve the use of acute dermatology services. METHOD: Information regarding referral source, information provided, urgency and diagnostic accuracy, time interval between referral and consultation date, and follow-up arrangements was collected via data sheet on each referral received. We confined the audit to acute referrals--ie, 'immediate and urgent cases' from general practitioners (GPs) that had been discussed with the dermatologist by phone, and internal referrals when an urgent consultation had been requested. RESULTS: More acute referrals came from other hospital departments (74%) than from general practitioners (26%). Acute referrers, especially hospital teams, tended to overestimate the urgency with which a dermatological condition needed to be seen. Information about inpatients was often considered inadequate for triage. GP referrals contained more useful information. GP referral diagnostic accuracy is in keeping with other studies (approximately 50%) but the diagnostic accuracy of hospital doctors is well below this level. All acute referrals were seen within the recommended timeframe. Follow-up patterns were similar (whether referrals came from general practitioners or hospital teams) but for both groups there was a relatively high failure to attend rate. CONCLUSIONS: Inappropriate referrals are time-consuming and reduce our capacity for seeing community patients on the waiting list. To improve referral triage, we recommend that a referral letter that clearly specifies the information that should be provided. The majority of acute referrals did not comply with the ACA guidelines. We recommend applying the ACA guidelines to internal acute dermatology referrals (as well as those from GPs).
dc.format.medium Electronic
dc.language eng
dc.relation.ispartofseries New Zealand Medical Journal
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher.
dc.subject Humans
dc.subject Acute Disease
dc.subject Interprofessional Relations
dc.subject Medicine
dc.subject Dermatology
dc.subject Family Practice
dc.subject Time Factors
dc.subject Hospital Departments
dc.subject Triage
dc.subject Appointments and Schedules
dc.subject Waiting Lists
dc.subject Referral and Consultation
dc.subject Health Services Accessibility
dc.subject Medical Audit
dc.subject New Zealand
dc.subject Practice Guidelines as Topic
dc.subject Specialization
dc.subject Clinical Research
dc.subject Health Services
dc.subject 8.1 Organisation and delivery of services
dc.subject 7.3 Management and decision making
dc.subject 11 Medical and Health Sciences
dc.title Audit of acute referrals to the Department of Dermatology at Waikato Hospital: Comparison with national access criteria for first specialist appointment
dc.type Journal Article
pubs.issue 1192
pubs.begin-page U849
pubs.volume 117 2022-04-18T23:25:32Z
dc.rights.holder Copyright: NZMA en
dc.identifier.pmid 15107871 (pubmed)
pubs.publication-status Published
dc.rights.accessrights en
pubs.subtype Article
pubs.elements-id 54990 Medical and Health Sciences School of Medicine Medicine Department
dc.identifier.eissn 1175-8716
pubs.record-created-at-source-date 2022-04-19

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