Communication at the primary/secondary care interface : a review of the literature and a stakeholder analysis

Abstract

INTRODUCTION Information linkage' between primary healthcare providers and secondary care providers in Mater Dei Hospital has traditionally been poor in Malta. The ticket of referral and the discharge letter have traditionally been the only way continuation of care is communicated via the two sets of providers and these have been criticized in terms of content, completion or for their absence on many occasions. The aim of this study was to assess the current changing situation and recommend measures that could be taken to improve matters in the foreseeable future. METHODOLOGY A qualitative methodological approach was conducted during March-April 2016. Semi-structured interviews were performed on five key personnel across the primary- secondary care interface. Respondents were asked on their views on the current referral process, the current discharge process, and primary/secondary care collaboration for the management of chronic diseases. Subsequent questions explored the possible negative aspects for each interface point and what measures could be used to improve them. CONCLUSION A multi-faceted problem requires a multi-faceted approach encompassing changes in the current business process, improvements in communication at the referral and discharge stages, and having robust information technology support.