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Improving the quality of outpatient clinic letters using the Sheffield Assessment Instrument for Letters (SAIL)

Adam T Fox1, Roger D Palmer, James G M Crossley

  • 1Luton and Dunstable Hospital NHS Trust, Luton, UK. adam.fox@btinternet.com

Medical Education
|July 24, 2004
PubMed

Insights

Improving outpatient letters significantly enhances communication between hospital and primary care doctors. The Sheffield Assessment Instrument for Letters (SAIL) tool demonstrated a powerful educational impact, aiding clinical governance.

Area of Science:

  • Medical Communication
  • Health Services Research
  • Quality Improvement in Healthcare

Background:

  • Effective communication between hospital specialists and primary care physicians is crucial for patient care continuity.
  • Outpatient letters are a primary method for this communication, but their quality can vary.
  • Existing methods for assessing letter quality may lack reliability or feasibility.

Purpose of the Study:

  • To enhance the quality of outpatient letters used for interprofessional communication.
  • To evaluate the effectiveness of the Sheffield Assessment Instrument for Letters (SAIL) as a quality improvement tool.
  • To assess the educational impact of feedback derived from the SAIL tool.

Main Methods:

  • A single-centre study conducted in a general pediatric outpatient department.
  • Seven hospital practitioners each provided 15 outpatient letters on two separate occasions.
  • Letters were assessed using the Sheffield Assessment Instrument for Letters (SAIL) by hospital doctors and general practitioners (GPs), with individualized feedback provided after the first assessment.

Main Results:

  • A statistically significant improvement in the mean quality scores of outpatient letters was observed (P = 0.001).
  • The mean quality score increased from 23.3 to 26.6 after the intervention.
  • All participating doctors completed the audit cycle, indicating feasibility and engagement.

Conclusions:

  • The Sheffield Assessment Instrument for Letters (SAIL) is a feasible and reliable tool for assessing outpatient letter quality.
  • The study demonstrates the significant educational impact of feedback provided through the SAIL tool.
  • This approach shows potential for medical appraisal and revalidation, supporting clinical governance requirements for quality improvement.
Abstract

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