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Evaluation of specialist referrals at a rural health care clinic.

Publication ,  Journal Article
Biggerstaff, ME; Short, N
Published in: Journal of the American Association of Nurse Practitioners
July 2017

Transition to a value-based care system involves reducing costs improving population health and enhancing the patient experience. Many rural hospitals must rely on specialist referrals because of a lack of an internal system of specialists on staff. This evaluation of the existing specialist referrals from primary care was conducted to better understand and improve the referral process and address costs, population health, and the patient experience.A 6-month retrospective chart review was conducted to evaluate quality and outcomes of specialty referrals submitted by 10 primary care providers. During a 6-month period in 2015, there was a total of 13,601 primary care patient visits and 3814 referrals, a referral rate of approximately 27%.The most striking result of this review was that nearly 50% of referred patients were not making the prescribed specialist appointment. Rather than finding a large number of unnecessary referrals, we found overall referral rates higher than expected, and a large percentage of our patients were not completing their referrals.The data and patterns emerging from this investigation would guide the development of referral protocols for a newly formed accountable care organization and lead to further quality improvement projects: a LEAN effort, dissemination of results to clinical and executive staff, protocols for orthopedic and neurosurgical referrals, and recommendations for future process improvements.

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Published In

Journal of the American Association of Nurse Practitioners

DOI

EISSN

2327-6924

ISSN

2327-6886

Publication Date

July 2017

Volume

29

Issue

7

Start / End Page

410 / 414

Related Subject Headings

  • Task Performance and Analysis
  • Specialization
  • Rural Health Services
  • Retrospective Studies
  • Referral and Consultation
  • Primary Health Care
  • North Carolina
  • Humans
  • 1110 Nursing
 

Citation

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ICMJE
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Biggerstaff, M. E., & Short, N. (2017). Evaluation of specialist referrals at a rural health care clinic. Journal of the American Association of Nurse Practitioners, 29(7), 410–414. https://doi.org/10.1002/2327-6924.12480
Biggerstaff, Mary Ellen, and Nancy Short. “Evaluation of specialist referrals at a rural health care clinic.Journal of the American Association of Nurse Practitioners 29, no. 7 (July 2017): 410–14. https://doi.org/10.1002/2327-6924.12480.
Biggerstaff ME, Short N. Evaluation of specialist referrals at a rural health care clinic. Journal of the American Association of Nurse Practitioners. 2017 Jul;29(7):410–4.
Biggerstaff, Mary Ellen, and Nancy Short. “Evaluation of specialist referrals at a rural health care clinic.Journal of the American Association of Nurse Practitioners, vol. 29, no. 7, July 2017, pp. 410–14. Epmc, doi:10.1002/2327-6924.12480.
Biggerstaff ME, Short N. Evaluation of specialist referrals at a rural health care clinic. Journal of the American Association of Nurse Practitioners. 2017 Jul;29(7):410–414.
Journal cover image

Published In

Journal of the American Association of Nurse Practitioners

DOI

EISSN

2327-6924

ISSN

2327-6886

Publication Date

July 2017

Volume

29

Issue

7

Start / End Page

410 / 414

Related Subject Headings

  • Task Performance and Analysis
  • Specialization
  • Rural Health Services
  • Retrospective Studies
  • Referral and Consultation
  • Primary Health Care
  • North Carolina
  • Humans
  • 1110 Nursing