The aim of this study was to assess whether appropriateness of referrals could be improved in a single ENT unit.
Initial audit was undertaken prospectively, over a two week period. Referral standards were assessed with reference to previously locally published departmentally-developed guidelines. After the initial audit a comprehensive implementation plan was developed. Three months after implementing the change, a second prospective audit was undertaken. Data was analysed using simple statistical methods.
In the initial audit (n=133) inappropriate referrals were 40% (n=53) and of these patients 68% (n=36) were deemed "not an emergency". A re-audit was undertaken for a period of two weeks. Inappropriate referrals comprised 16% of attendees (n=14). The change of inappropriate referrals was found to be statistically significant (n=53(40%)vs.n=14(16%),X2=14.29,p<0.01).
The results showed a statistically significant improvement in referral appropriateness as the unstructured clinic system was replaced by an appointment based system.