[Improvement in the internists' outpatient report using a time control system and systematic feedback by the general practitioner].

Abstract

OBJECTIVE: To establish if the letters from internists contain the information wanted by the GP and if the quality of these letters can be improved by a time control system and by systematic feedback from the GP to the internist. DESIGN: Questionnaire study. SETTING: Outpatient clinic for General Internal Diseases, University Hospital Nijmegen. METHOD: The 284 GPs in the region were polled about their requirements for information in terms of speed and contents. Patient files were examined to find out to what extent the outpatient department met these requirements. The outpatient clinic physicians were informed of the findings. Subsequently a control system was introduced; every letter was accompanied by a postage-paid evaluation card inviting the GPs to comment. The findings obtained were reported back to the outpatient department physicians. RESULTS: GPs appreciated a preliminary report after the first outpatient visit (response rate: 70%). In the final report, they particularly wanted information on diagnosis, treatment, management to be conducted and information given to the patient. The control system accelerated final reporting. Of the evaluation cards 75% were returned; the explanation concerning diagnosis and treatment was experienced as sufficient, while mention of the information given to the patient was not always found satisfactory. CONCLUSION: The internists' letters did not optimally meet the GPs' need of information. A 'time control system' accelerated the final reporting on newly referred patients. A systematic feedback of the GPs' opinions on the quality of the letters improved the alignment of the information provided with the GPs' requirements.