Outpatient clinic letters in ENT. Is there any margin of improvement?

Outpatient clinic letters are a widely used and effective means of communication between hospital staff and general practitioners. This study audited the letter format used by consultants and specialist registrars (SpRs) at an otolaryngology clinic to assess the readability of different formats.

The two-cycle audit was performed at the Otolaryngology Clinic at Guy's and St Thomas' NHS Foundation Trust in London, England. A readability score (0-4) was assigned to the letters as an indication of how easy it was to extract information from structured or unstructured (paragraph) format letters.

In the first cycle, 71.91% of the SpR letters followed a structured format and had an overall mean readability score of 2.87/4; 46.58% of the consultant letters followed a structured format and had an overall mean readability score of 1.25/4. In the second cycle, after the results of the first audit were presented to the participating physicians, 84.72% of the SpR letters followed a structured format and had an overall mean readability score of 3.41/4. Consultants followed a structured format in 52.56% of the letters, which had an overall mean readability score of 2.04/4.

We found that a structured format for outpatient letters was better than unstructured format. This audit helped change the structure and consequently the readability scores of the clinic letters.