Reducing ear, nose and throat (ENT) waitlists: implications of a referral audit

Jacups, Susan P., and McConnon, Kate M. (2019) Reducing ear, nose and throat (ENT) waitlists: implications of a referral audit. Health Policy, 123 (3). pp. 333-337.

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Introduction: Many specialist waitlists in Australian hospitals are long. One reason anecdotally reported for this is poor alignment of referrals with current recommended guidelines. This paper reports the findings of an audit undertaken in 2017 for ear, nose and throat (ENT) surgeon referrals submitted by primary health centres within Cape York, Australia.

Materials and methods: 54 long-wait ENT referrals were reviewed against referral criteria for ENT presentations using the Clinical Prioritization Criteria (CPC) and two routinely applied clinical primary health care guidelines; with findings reported alongside patient demography.

Results: All of the long wait ENT referrals in the sample were for remote living Indigenous Australians, most were children (93%). One fifth of referrals fulfilled all referral criteria and were appropriate (22%); one third required further informaiton to support the referral, either audiology or clinical history (30%); and half were inappropriate referrals (48%).

Conclusion: Although many referral submissions did not adhere to CPC or routine guidelines, this audit enabled the identification of improvements to the referral system including the development of a checklist and flow-chart, plus patient information resources aimed at improving patient adherence. A case can be made for a new service delivery model that provides ongoing primary health education and facilitates improved ENT access. These strategies may improve ENT referral quality and decongest current ENT specialist waitlists, while offering improved primary health care management of ear presentations.

Item ID: 57393
Item Type: Article (Research - C1)
ISSN: 1872-6054
Keywords: Indigenous; otits media; medical audit; guideline adherence; hospital referrals; otolaryngology
Copyright Information: Copyright © 2019 Elsevier B.V. All rights reserved.
Date Deposited: 13 Mar 2019 04:20
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems @ 100%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920299 Health and Support Services not elsewhere classified @ 100%
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