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User satisfaction with referrals at a collaborative virtual reference service Virtual reference services, Reference services, Referrals, User satisfaction
Nahyun Kwon
Information Research: an international electronic journal , 2006,
Abstract: Introduction. This study investigated unmonitored referrals in a nationwide, collaborative chat reference service. Specifically, it examined the extent to which questions are referred, the types of questions that are more likely to be referred than others, and the level of user satisfaction with the referrals in the collaborative chat reference service. Method. The data analysed for this study were 420 chat reference transaction transcripts along with corresponding online survey questionnaires submitted by the service users. Both sets of data were collected from an electronic archive of a southeastern state public library system that has participated in 24/7 Reference of the Metropolitan Cooperative Library System (MCLS). Results. Referrals in the collaborative chat reference service comprised approximately 30% of the total transactions. Circulation-related questions were the most often referred among all question types, possibly because of the inability of 'outside' librarians to access patron accounts. Most importantly, user satisfaction with referrals was found to be significantly lower than that of completed answers. Conclusion. The findings of this study addressed the importance of distinguishing two types of referrals: the expert research referrals conducive to collaborative virtual reference services; and the re-directional local referrals that increase unnecessary question traffic, thereby being detrimental to effective use of collaborative reference. Continuing efforts to conceptualize referrals in multiple dimensions are anticipated to fully grasp complex phenomena underlying referrals.
Out-of-hours demand for GP care and emergency services: patients' choices and referrals by general practitioners and ambulance services
Eric P Moll van Charante, Pauline CE van Steenwijk-Opdam, Patrick JE Bindels
BMC Family Practice , 2007, DOI: 10.1186/1471-2296-8-46
Abstract: During two four-month periods (five-year interval), a prospective cross-sectional study was performed for a Dutch population of 62,000 people. Data were collected on all patient contacts with one GP cooperative and three AEDs bordering the region.Overall, GPs handled 88% of all out-of-hours contacts (275/1000 inhabitants/year), while the AED dealt with the remaining 12% of contacts (38/1000 inhabitants/year). Within the AED, the self-referrals represented a substantial number of contacts (43%), although within the total out-of-hours demand they only represented 5% of all contacts. Self-referrals were predominantly young adult males presenting with an injury, nineteen percent of whom had a fracture. Compared to self-referrals, patients who were referred by the GP or brought in by the ambulance services were generally older and were more frequently admitted for both injury and non-injury (p < 0.01 for all differences).The GP cooperative deals with the large majority of out-of-hours problems presented. Within the total demand, self-referrals constitute a stable, yet small group of patients, many of whom seem to have made a reasonable choice to attend the AED. The GPs and the ambulance services appear to be effectively selecting the problems that are presented to the AED.Following the UK and Denmark, over the last five years, Dutch provision of out-of-hours primary health care has shifted from practice-based services towards large-scale general practitioner (GP) cooperatives [1,2]. There are currently more than 130 GP cooperatives in the Netherlands, generally with 40 to 120 full-time participating GPs, which cover over 90% of the entire Dutch population and serve between 50,000 and 500,000 people. Most GP cooperatives are known to lie in close proximity of the hospital. Although most GP cooperatives operate independently from the hospital, recently, some have decided to integrate with the local Accident & Emergency Department (AED), to form one out-of-hours emergency c
Physician advice on avoiding secondhand smoke exposure and referrals for smoking cessation services
Judy Kruger, Angela Trosclair, Abby Rosenthal, Steve Babb, Robert M Rodes
Tobacco Induced Diseases , 2012, DOI: 10.1186/1617-9625-10-10
Abstract: The purpose of this paper is to examine primary care provider (obstetricians/gynecologists, pediatricians, and general practitioners) advice regarding SHS exposure and referral to cessation programs. Using data from the 2008 DocStyles survey (n?=?1,454), we calculated the prevalence and adjusted odds ratios for offering patients advice regarding SHS exposure and referring adults who smoked or used other tobacco products to a cessation program.The current study found that among a convenience sample of primary care providers, 94.9% encouraged parents to take steps to protect children from SHS exposure, 86.1% encouraged smokers to make their homes and cars smoke-free, and 77.4% encouraged nonsmokers to avoid SHS exposure. Approximately 44.0% of primary care providers usually or always referred patients who smoked or used tobacco products to cessation programs such as a quitline, a group cessation class, or one-on-one counseling.Findings from a convenience sample of primary care providers who participated in a web-based survey, suggests that many primary care providers are advising parents to protect children from SHS exposure, encouraging patients who smoke to maintain smoke-free homes and cars, and advising smokers on ways to avoid exposing others to SHS. Healthcare providers are encouraged to advise patients to avoid SHS exposure and to refer patients who use tobacco products to cessation services.
Implementing nursing best practice guidelines: Impact on patient referrals
Nancy Edwards, Barbara Davies, Jenny Ploeg, Tazim Virani, Jennifer Skelly
BMC Nursing , 2007, DOI: 10.1186/1472-6955-6-4
Abstract: A prospective before and after design was used. For each BPG topic, referral resources were identified. Information about these resources was presented at education sessions for nurses. Pre- and post-questionnaires were completed by a random sample of 257 nurses at 7 hospitals, 2 home visiting nursing services and 1 public health unit. Average response rates for pre- and post-implementation questionnaires were 71% and 54.2%, respectively. Chart audits were completed for three BPGs (n = 421 pre- and 332 post-implementation). Post-hospital discharge patient interviews were conducted for four BPGs (n = 152 pre- and 124 post-implementation).There were statistically significant increases in nurses' familiarity with resources for all BPGs, and self-reported referrals to specific services for three guidelines. Higher rates of referrals were observed for services that were part of the organization where the nurses worked. There was almost a complete lack of referrals to Internet sources. No significant differences between pre- and post-implementation referrals rates were observed in the chart documentation or in patients' reports of referrals.Implementing nursing BPGs, which included recommendations on patient referrals produced mixed results. Nurses' familiarity with referral resources does not necessarily change their referral practices. Nurses can play a vital role in initiating and supporting appropriate patient referrals. BPGs should include specific recommendations on effective referral processes and this information should be tailored to the community setting where implementation is taking place.The provision of continuous, comprehensive client care is critical in today's complex health care system where clients experience shorter hospital stays, and move quickly from one care setting to another. Continuity of care is an essential feature of a well-functioning health care system. It is demarcated by coherent and linked services and results from "good information flow
High risk pregnancy referrals adequacy in the Basic Health Services of Sobral, Ceará, Brazil
José Juvenal Linhares,Samille Frota Monte Coelho,érica Monteiro Vieira,Eugênio Araújo Costa
Einstein (S?o Paulo) , 2009,
Abstract: Objective: To describe the appropriateness of referrals of high-risk pregnancies in the basic healthcare network of Sobral, in Ceará, Brazil. Methods: A descriptive quantitative study. The medical files of 173 pregnant patients referred to the high-risk outpatient clinic of Centro de Especialidades Médicas of Sobral, during the period from July 2006 to April 2007, were analyzed. Variables analyzed were correctness of the referrals, professionals who made them, causes and origins of the referrals, and age bracket of the patients referred. The referrals were divided into “appropriate” and “inappropriate”, according to the classification of risk established by the technical manual of the Ministry of Health. Rresults: Of the 173 cases, 102 (59%) were considered appropriate/correct, and 71 (41%) referrals were considered inappropriate/incorrect. The referrals were divided according to the professional class of the referring individuals: physicians or nurses. Of the 173 referrals, 49 (28.3%) were made by physicians, and 124 (71.7%) by nurses. Of the 49 patients referred by physicians, 39 (79.6%) were considered correct. Of the 124 referrals made by nurses, 63 (50.8%) were considered incorrect, revealing a significant difference between the groups (p < 0.00001). The most common causes of referrals of pregnant patients were hypertensive syndromes (23.6%), physiological modifications of pregnancy (22.6%), prolonged pregnancy (15.1%), and diabetes (12.3%). Cconclusions: There was a low rate of appropriate/correct referrals. There is a need for training in the basic healthcare network for quality prenatal care, with special emphasis on referring nurses.
How the Most Trusted Venues for Health-Related Information Influence Physician Referrals to Smoking Cessation Services  [PDF]
Judy Kruger,Angela Trosclair,Crystal Bruce,Diane Beistle
ISRN Public Health , 2012, DOI: 10.5402/2012/256301
Abstract: Public health programs seek to educate physicians by using a variety of venues. Therefore, it is important to understand which health information sources physicians are using and how these sources affect referrals. We explored how venues for health-related information affect physicians' referral practices to smoking cessation services. The 2008 DocStyles survey asked physicians to rank a list of their most trusted sources of health-related information. The analysis was restricted to 1,617 physicians who responded to all variables of interest. In this sample, the most trusted sources of health-related information cited by physicians were medical journals (95.9%), government health agencies (82.2%), other physicians (76.4%), professional medical societies (75.2%), and medical Web sites or podcasts (65.9%). Medical providers were more likely to refer tobacco users to cessation services if they used professional medical societies as a source to obtain patient health-related information, compared with medical providers not using this source (multivariate odds ratio?=?1.31; 95% confidence interval?=?1.03–1.66). Physicians use many health information sources. Therefore, to reach physicians effectively, a broad dissemination of guidelines and best practices in tobacco control is needed and should include information for medical societies. 1. Introduction Tobacco use remains the single most preventable cause of disease and death in the United States. In 2010, 19.3% of the adult population reported smoking every day or some days [1]. Physicians are one of the most important sources of information about smoking cessation for patients who use tobacco [2]. Approximately 84% of the US population visit a primary care provider each year, and they average 2.1 visits a year, which provide ample opportunity for physicians and their staff to deliver brief, effective, tobacco cessation interventions to their patients who use tobacco [3]. Physician advice increases the number of patients who attempt to quit smoking and succeed [4, 5]. During the office medical visit or at the patient’s bedside, physicians are frontline educators and treatment providers, and the U.S. Public Health Service (PHS) guidelines confirm the physician’s role as essential for providing tobacco dependence services [3]. The PHS clinical practice guidelines for tobacco use and dependence recommend that physicians follow the 5?A’s when helping patients quit: ask, advise, assess, assist, and arrange followup [3]. Unfortunately, physicians do not routinely follow all of these guidelines. A report about
Low vision services for children in Tanzania
Elizabeth Kishiki,Paul Courtright
Community Eye Health Journal , 2012,
Abstract: The Kilimanjaro Centre for Community Ophthalmology (KCCO) has been involved in a five-year pilot project to improve low vision services for children in Tanzania. Low vision services were limited to a few tertiary hospitals and were accessible to only a few children.
Design of Children Entertainment Facilities  [cached]
Mei Li
Asian Social Science , 2009, DOI: 10.5539/ass.v4n12p138
Abstract: In this paper, mainly through analysis of problems on existing children entertainment facilities and the impact of children entertainment facilities on children psychological development, it is to be discussed about the key point of children entertainment facilities design.
Quality of psychiatric referrals to secondary-level care
W Struwig, PJ Pretorius
South African Journal of Psychiatry , 2009,
Abstract: Objectives. This study examined the quality of referrals to secondary-level outpatient psychiatric services rendered by the Department of Psychiatry, University of the Free State. Referral letters were evaluated according to specific quality criteria. Aspects that would enable secondary-level doctors to make informed decisions in terms of further management and need for special investigations were specifically considered. Design. A descriptive study design was used, and convenience sampling included all referrals to the unit over a 6-month period (June - November 2007). All referral letters were screened according to a checklist designed for this study. Setting. The study was undertaken at the Psychiatry Outpatient Department of the Pelonomi Provincial Hospital in Bloemfontein, which functions as a secondary-level referral centre for mental health in the southern Free State. Outcome measures. Descriptive statistics (percentages, means and standard deviations) were used to summarise results. Results. Two hundred and sixty-three referral letters were included in the study. Less than 20% of the referral letters included information on previous psychiatric consultations, current psychotropic medication, the outcome of physical examinations, and results of special investigations. Only 17 (6%) referral letters indicated a preliminary diagnosis according to an officially recognised classification system. Conclusion. There was conclusive evidence that the quality of referrals to the Psychiatry Department was generally inadequate. A need for more effective referral strategies was identified.
An Assessment of Satisfaction with Ambulatory Child Psychiatry Consultation Services to Primary Care Providers by Parents of Children with Emotional and Behavioral Needs: The Massachusetts Child Psychiatry Access Project University of Massachusetts Parent Satisfaction Study  [PDF]
Yael Dvir,Melodie Wenz-Gross,Mary Jeffers-Terry
Frontiers in Psychiatry , 2012, DOI: 10.3389/fpsyt.2012.00007
Abstract: This study evaluated parents’ experience with University of Massachusetts (UMass) Child Psychiatry Access Project (MCPAP), a consultation service to primary care providers (PCP), aimed at improving access to child psychiatry. Parent satisfaction questionnaire was sent to families referred to UMass MCPAP by their PCP, asking about their concerns leading to the referral, the satisfaction from the service provided, adequacy of the follow up plan, and outcome. Seventy-nine percent of parents agreed or strongly agreed that the services provided were offered in a timely manner. Fifty percent agreed or strongly agreed that their child’s situation improved following their contact with the services. Sixty-nine percent agreed or strongly agreed that the service met their family’s need. The results suggest moderate to high parental satisfaction with MCPAP model, but highlight ongoing challenges in making successful referrals for children’s mental health services in the community, following MCPAP recommendations.
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