A randomised controlled crossover trial to assess the effectiveness of, preference for and length of structured reply letters when communicating with referring practitioners

摘要

Title A randomised controlled crossover trial to assess the effectiveness of, preference for and length of structured reply letters when communicating with referring practitioners Statement “I have made this letter longer than usual as I lack the time to make it short” (Blasie Pascal 1623-1662) Objectives To identify whether : 1. Structured reply letters from consultants were more effective at communicating with and/ or preferred by practitioners when compared to consultants’ standard reply letters. 2. There were differences in the length of the two formats. Null Hypothesis No significant difference exists between practitioner’s awareness of key patient information when receiving either the structured consultant reply letter or the standard consultant reply letter. No significant difference exists between the word counts of the two letter formats. Design Randomised controlled crossover trial. Setting Liverpool University Dental Hospital (LUDH). Participants and methods Participants were recruited from practitioners referring orthodontic patients to LUDH. Seventy five practitioners were stratified by consultant and randomised in blocks to receive either the structured or standard letter first, followed by the alternative format six weeks later. For both groups, the word count was recorded by the secretaries. ‘Knowledge and satisfaction’ questionnaires were dispatched with the letters, completed by practitioners and returned to the department. Outcome measures The primary outcome measure was the practitioners’ awareness of the key information contained within the letter. The secondary outcome measure was the secretarial typing times for the letters. Results The response rate was 87%. There was a statistically significant improvement in practitioners’ awareness of their patient’s status (odds ratio 8.84 95% CI 1.08, 72.52) and the action required (odds ratio 4.13 95% CI 1.10, 15.45) after receiving the structured letter. Practitioners showed a strong preference (p