The Finnish national asthma programme: communication in asthma care – quality assessment of asthma referral letters

Leena Esteri Tuomisto · Marina Erhola · Kaila Minna · Pirkko E Brander · Kauppinen Ritva · Hannu Puolijoki +1 more

16 citations0/0 files storedJournal of Evaluation in Clinical Practice

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Healthcare Systems and Technology Asthma and respiratory diseases Primary Care and Health Outcomes

Abstract

AIMS AND OBJECTIVES: The Finnish National Asthma Programme, which was launched in year 1994, considered the management of asthma as a community problem. The role of the primary health care in the management of asthma was emphasized. Optimal asthma management includes good communication between health care professionals. Referral letters are an accepted tool for evaluation of the communication process. The aim of this study was to assess the quality of asthma-related referral letters. METHODS: All non-acute referral letters (n=3176) to three pulmonary departments were screened in 2001 and all those related to asthma were included (n=1289). The 14 previously derived asthma-specific criteria were applied: occupation, smoking, known allergies, current medication, other diseases, onset of symptoms, wheezing, dyspnoea, specified dyspnoea, cough, specified cough, use of asthma medication, peak-flow follow-up or spirometry with bronchodilatation test as an attachment. The study group was prepared to accept the maximum of 30% of the referral letters to be of poor quality. RESULTS: Twenty-one per cent of the referral letters were graded good, 34% satisfactory and 45% poor. Information on wheezing, smoking habits and current medication was mentioned in 44%, 42% and 41% of asthma letters respectively. CONCLUSIONS: The Finnish National Asthma Programme calls for optimizing communication between doctors. The proportion of poor letters was 50% higher than the preset standard and clearly indicates a need for improvement. We found several issues, which need to be better communicated (smoking, lung function tests, wheezing, medication) when referring a patient with suspected asthma.

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1992Communication between general practitioners and consultants: what should their letters contain?2003Communication at the interface: do better referral letters produce better consultant replies?1982Factors related to an effective referral and consultation process.1994Do Clinicians Tell Each Other Enough? An Analysis of Referral Communications in Two Specialties 2004Views of doctors on clinical correspondence: questionnaire survey and audit of content of letters 1994Improving communication with specialists: The case of an oncology clinic 1987Notifying general practitioners about deaths in hospital: an audit.

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