What makes a good specialty referral?

Abstract

Referrals between medical and surgical specialties are an important communication challenge in healthcare. Yet there is little guidance on how to make a competent referrals. We aimed to clarify the qualities of a good referral by means of a qualitative study. Semi-structured interviews and email correspondence with a predefined topic schedule were conducted with participants purposively sampled to include a wide range of specialties.  The results were collated and coded using the Framework Method. These were then qualitatively analysed and common themes emerged. A total of 51 specialists from 29 clinical specialties responded. The broad themes identified included a standardised structure, appropriate method and relevant content of referral. Many clinicians cited a well-organised structure with a clear clinical question as key to a good referral. Many also preferred a ‘headliner’ summary sentence to give an overview of the content of the referral. Perceived barriers to a good referral included staffing levels, high workload and complexity of the referral process. We have identified common themes that can be applied to referrals made to a wide range of clinical specialities. The q-SBAR (question-Situation Background Assessment Referral) method is one way that such a referral could be structured.