Assessing and improving the ticket of referral to a national vascular clinic

Abstract

Purpose: Patients requiring specialist treatment at the national vascular clinic are referred through a ticket of referral completed by a referring clinician. This ticket of referral is intended to provide the vascular specialist with the relevant information to determine the degree of urgency of the referral. In 2009 a study was conducted locally where the quality of the tickets of referral was evaluated. Research Questions: Has there been a change in quality in the tickets of referral since the study conducted in 2009? How can the ticket of referral be improved in practice? What information should ideally be included in the ticket of referral to the vascular clinic? Methodology: The research design employed was a Mixed Methods Design. For the quantitative phase, 200 tickets of referral received at the vascular clinic were evaluated. Statistics were applied to identify any statistically significant differences between the results of the two studies. The qualitative part consisted of a Delphi method, where seven experts in the vascular field were invited to participate. Results: The patient’s demographic and referring doctor’s details showed a significant improvement compared to the study performed in 2009. However, the information relating to vascular pathology remained the same and some even deteriorated. Additionally, the legibility of the tickets of referral fared worse than the previous study. Through the Delphi method, the respondents were in favour of a new referral specifically to the vascular clinic as this would serve as a checklist for the referring doctor to provide all the required information. Conclusions: It was concluded that the quality of the current tickets of referral to the vascular clinic was poor and remained poor compared to ten years ago, if not worse. Improvement mainly should be focused on the vascular related information and legibility of the tickets of referral. Therefore, referring doctors’ training is recommended together with a new vascular referral in both online and paper form.