Can we improve dysphagia referrals?

We set out to examine whether a multidisciplinary out-patient dysphagia referral triage service would shorten the duration of a patient's referral process and direct patients to the correct specialty. A review was carried out of patients referred with dysphagia before and after the introduction of a multidisciplinary out-patient dysphagia service, from February 2001 to April 2001 and from January 2002 to March 2002, inclusive. One hundred and eight patients were referred in total. The length of time until the first appointment was reduced from four to three weeks (median; range one to 23; p<0.001). The number of instrumental investigations was reduced, with a median of one instrumentation per patient under the new service, compared with two in those under the standard service (p<0.001). Attendance to hospital was also reduced, with 45 per cent of patients under the new service requiring only one appointment, compared with 13 per cent in those under the standard service (p<0.001). The multidisciplinary out-patient dysphagia service was associated with significant reductions in waiting times, in the number of instrumental investigations and in the duration of the patient's referral process.