About: Referrals to a pediatric emergency department of a tertiary care teaching hospital before and after introduction of a referral education module

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About: Referrals to a pediatric emergency department of a tertiary care teaching hospital before and after introduction of a referral education module - a quality improvement study Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Referrals to a pediatric emergency department of a tertiary care teaching hospital before and after introduction of a referral education module - a quality improvement study
Creator	Bansal, Arun Bharti, Bhavneet Ezhumalai, Gopalakrishnan Jayashree, Muralidharan Nallasamy, Karthi
Source	PMC
abstract	BACKGROUND: Provision of timely care to critically ill children is essential for good outcome. Referral from smaller peripheral hospitals to higher centers for intensive care is common. However, lack of an organized referral and feedback system compromises optimal care. We studied the quality of referral letters coming to our Emergency Department (ED) with respect to their demography, association with severity of illness and mortality before and after referral education. METHODS: Our study was completed in three phases in the Pediatric ED; Pre-intervention, Intervention and Post intervention phases. Quality of referral letter was matched with a quality checklist proforma and graded as ‘good’, ‘fair’ and ‘poor’ if it scored > 7, 5–7 and < 5 points respectively. A peer reviewed referral education module was prepared using case studies, expert opinions, and lacunae observed in the first phase and administered to health care providers (HCP’s) of referring hospitals. Quality of referral letter was compared between pre and post intervention phases. RESULTS: Most referrals belonged to the neighboring states of Punjab (48.2%) and Haryana (22.4%). Major referring hospitals were from public sector (80.9%), of which the teaching hospitals topped the list (53.6%). Government run ambulance services (85.5%) was commonest mode of transport used and need for a PICU bed and/or mechanical ventilation (50.4%) was the commonest reason for referral. The post intervention phase saw a significant decline in the proportion of poor (93.2 vs.78.2%; p = 0.001) and a significant increase in the proportion of fair (6.1 vs 18%; p = 0.001) and good referral letters (0.7 vs 18%; p = 0.001). The proportion of children with physiological decompensation at triage had reduced significantly in the post intervention phase [513 out of 1403 (36.5%) vs. 310 out of 957 (32.3%); p = 0.001]. CONCLUSION: Referral education had significantly improved the quality of referral letters. Proportion of children with physiological decompensation at triage had decreased significantly after referral module. This change suggests sensitization of the peripheral hospitals towards a better referral process. Continued multifaceted approach will be required for sustained and increased benefits.
has issue date	2020-08-17(xsd:dateTime)
bibo:doi	10.1186/s12913-020-05649-w
has license	cc-by
sha1sum (hex)	aed897e39a04a5e351cbdf511804babf7a2d5230
schema:url	https://doi.org/10.1186/s12913-020-05649-w
resource representing a document's title	Referrals to a pediatric emergency department of a tertiary care teaching hospital before and after introduction of a referral education module - a quality improvement study
has PubMed Central identifier	PMC7430091
schema:publication	BMC Health Serv Res
resource representing a document's body	covid:aed897e39a04a5e351cbdf511804babf7a2d5230#body_text
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