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Psoriasis consultation audit: a two-centre study
D Shuttleworth1, A Y Finlay, M Rademaker
1Department of Medicine (Dermatology), University of Wales College of Medicine, Heath Park, Cardiff, U.K.
The British Journal of Dermatology
|July 1, 1990
Summary
Hospital note-keeping for psoriasis patients was assessed. While junior staff recorded more details, communication with general practitioners was poor, impacting patient follow-up and consultant access.
Area of Science:
- Dermatology
- Healthcare Management
- Medical Auditing
Background:
- Adequate hospital note-keeping is crucial for patient care continuity and effective communication within healthcare systems.
- Psoriasis management requires detailed patient records to track symptoms, treatment efficacy, and patient outcomes.
- Previous assessments of medical record-keeping practices have indicated variability in quality and completeness.
Purpose of the Study:
- To assess the adequacy of hospital note-keeping for patients with psoriasis across two teaching hospitals.
- To identify variations and similarities in record-keeping practices between different staff levels and hospital centers.
- To evaluate the effectiveness of communication between hospital clinics and general practitioners, particularly concerning patient default.
Main Methods:
- A retrospective audit of case notes for 100 patients diagnosed with psoriasis at two teaching hospitals.
- Criteria for adequate note-keeping were established in consultation with 60 British dermatologists.
- Data collected included patient symptoms, disability, psoriasis type, visit frequency, discharge information, and communication with general practitioners.
Main Results:
- Record-keeping patterns were similar across both teaching hospitals.
- Non-consultant (junior) staff generally completed records more comprehensively than consultant (senior) staff.
- Significant differences were noted between centers regarding the recording of patient symptoms, disability, psoriasis type, and pre-discharge visits to general practitioners.
- Communication to general practitioners following patient default was consistently poor in both centers.
- Patients seen by non-consultant staff initially had a lower probability (1 in 8) of subsequent consultant review.
Conclusions:
- The case-note audit revealed consistent, yet suboptimal, record-keeping practices in psoriasis care at the studied teaching hospitals.
- Improvements in documentation, particularly concerning patient-reported outcomes and communication with primary care, are necessary.
- The audit process itself led to practical enhancements in record-keeping procedures within the participating centers.