Lost in translation: Telephone referrals to a tertiary neurology referral centre

Ir J Med Sci. 2023 Aug;192(4):1569-1572. doi: 10.1007/s11845-022-03194-5. Epub 2022 Oct 22.

Abstract

Background: Cork University Hospital acts as the tertiary referral centre for the HSE southern area, with a catchment population of 1.2 million [1]. The neurology registrars receive telephone consultations from hospitals and primary care practices in the region. While there have been a number of studies examining inpatient neurology consultations in Irish hospitals [2-6], there is a paucity of data examining the support provided by tertiary referral centres to other acute hospitals and primary care centres in their region.

Aims: The aim of this study is to define the workload of the neurology registrar with respect to telephone consultations and to examine the quality of these referrals.

Methods: All calls received from the 19th of October 2021 to the 25th of February 2022 were logged by the receiving registrar. Information collected pertained to the nature of the consult and completeness of the referral.

Results: The average volume of calls during the study period was six per week. The median call duration was 8 min. The cumulative time spent resolving outside calls during the study period was at least 41.25 hours. Sixty-three per cent of calls were from other acute hospitals in the region. Thirty-nine per cent of referrals were deemed incomplete with respect to either history, collateral history or examination.

Conclusions: This is a necessary service in a system that is not adequately resourced to provide specialist led care in all hospitals. A greater emphasis on complete and accurate referrals, along with robust communication and documentation, could reduce the inherent risk associated with such consultations.

Keywords: Acute hospital; Consults; Neurology; Referrals; Telephone.

MeSH terms

  • Communication
  • Humans
  • Neurology*
  • Referral and Consultation*
  • Telephone
  • Tertiary Care Centers