Abstract
IntroductionTo provide optimal care for patients with cancer, timely and efficient communication between healthcare providers is essential. In this study, we aimed to achieve consensus regarding the desired content of communication between general practitioners (GPs) and oncology specialists before and during the initial treatment of cancer.MethodsIn a two-round Delphi procedure, three expert panels reviewed items recommended for inclusion on referral and specialist letters.ResultsThe three panels comprised 39 GPs (42%), 42 oncology specialists (41%) (i.e. oncologists, radiotherapists, urologists and surgeons) and 18 patients or patient representatives (69%). Final agreement was by consensus, with 12 and 35 items included in the GP referral and the specialist letters, respectively. The key requirements of GP referral letters were that they should be limited to medical facts, a short summary of symptoms and abnormal findings, and the reason for referral. There was a similar requirement for letters from specialists to include these same medical facts, but detailed information was also required about the diagnosis, treatment options and chosen treatment. After two rounds, the overall content validity index (CVI) for both letters was 71%, indicating that a third round was not necessary.DiscussionThis is the first study to differentiate between essential and redundant information in GP referral and specialist letters, and the findings could be used to improve communication between primary and secondary care.
Highlights
To provide optimal care for patients with cancer, timely and efficient communication between healthcare providers is essential
In the Netherlands and other countries with a similar system, all inhabitants are registered with a general practitioner (GP)
As the electronic patient records of GPs and medical specialists are separate, the most common way of communication is the digital exchange of letters between GP and specialists [10]
Summary
To provide optimal care for patients with cancer, timely and efficient communication between healthcare providers is essential. We aimed to achieve consensus regarding the desired content of communication between general practitioners (GPs) and oncology specialists before and during the initial treatment of cancer. In the Netherlands and other countries with a similar system, all inhabitants are registered with a general practitioner (GP) This GP functions as gatekeeper and coordinator of healthcare. In countries with such a system, patients often consult their GP for support [6, 7] To provide this care in an optimal manner, timely and efficient information exchange is essential, both at time of diagnosis and during therapy [5, 8, 9]. As the electronic patient records of GPs and medical specialists are separate, the most common way of communication is the digital exchange of letters between GP (i.e. referral letters) and specialists (i.e. consultation and treatment) [10]
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