Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS) : unannounced simulated patient telephone call study in primary care

TY - JOUR

T1 - Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS) : unannounced simulated patient telephone call study in primary care

AU - Mellor, R. M.

AU - Sheppard, J. P.

AU - Bates, E.

AU - Bouliotis, G.

AU - Jones, Janet

AU - Singh, S.

AU - Skelton, J.

AU - Wiskin, C.

AU - Mcmanus, R. J.

PY - 2015/7/1

Y1 - 2015/7/1

N2 - BACKGROUND:Stroke is a leading cause of morbidity and mortality. Timely recognition and referral are essential for treatment.AIM:To examine the ability of receptionists in general practices to recognise symptoms of stroke and direct patients to emergency care.DESIGN AND SETTING:Unannounced simulated patient telephone calls and prospective cross-sectional survey study in general practices in the Birmingham and Solihull area.METHOD:A total of 52 general practices participated in a total of 520 simulated telephone calls, with 183 receptionists completing questionnaires. Logistic regression analyses were used to examine likelihood of referral for immediate care by ease of vignette recognition and number of common stroke symptoms present.RESULTS:General practice receptionists correctly referred 69% of simulated calls for immediate care. Calls classed as 'difficult' to recognise were less likely to be immediately referred. Compared with 'easy' calls: 'difficult' calls odds ratio (OR) 0.15, 95% confidence interval (CI) = 0.08 to 0.26; 'moderate' calls OR 0.55, 95% CI = 0.32 to 0.92. Similarly, calls including one or two 'FAST' symptoms were less likely to be referred immediately (compared with three FAST symptoms: one symptom OR 0.30, 95% CI = 0.13 to 0.72; two symptoms OR 0.35, 95% CI = 0.15 to 0.83).CONCLUSION:General practice receptionists refer patients with stroke for immediate care when they present with several symptoms; however, they are less likely to refer patients presenting with only one symptom or less common symptoms of stroke. Optimum management of acute stroke in primary care requires interventions that improve receptionists' knowledge of lesser-known stroke symptoms.

AB - BACKGROUND:Stroke is a leading cause of morbidity and mortality. Timely recognition and referral are essential for treatment.AIM:To examine the ability of receptionists in general practices to recognise symptoms of stroke and direct patients to emergency care.DESIGN AND SETTING:Unannounced simulated patient telephone calls and prospective cross-sectional survey study in general practices in the Birmingham and Solihull area.METHOD:A total of 52 general practices participated in a total of 520 simulated telephone calls, with 183 receptionists completing questionnaires. Logistic regression analyses were used to examine likelihood of referral for immediate care by ease of vignette recognition and number of common stroke symptoms present.RESULTS:General practice receptionists correctly referred 69% of simulated calls for immediate care. Calls classed as 'difficult' to recognise were less likely to be immediately referred. Compared with 'easy' calls: 'difficult' calls odds ratio (OR) 0.15, 95% confidence interval (CI) = 0.08 to 0.26; 'moderate' calls OR 0.55, 95% CI = 0.32 to 0.92. Similarly, calls including one or two 'FAST' symptoms were less likely to be referred immediately (compared with three FAST symptoms: one symptom OR 0.30, 95% CI = 0.13 to 0.72; two symptoms OR 0.35, 95% CI = 0.15 to 0.83).CONCLUSION:General practice receptionists refer patients with stroke for immediate care when they present with several symptoms; however, they are less likely to refer patients presenting with only one symptom or less common symptoms of stroke. Optimum management of acute stroke in primary care requires interventions that improve receptionists' knowledge of lesser-known stroke symptoms.

KW - general practice

KW - health services administration

KW - medical receptionists

KW - patient simulation

KW - questionnaires

KW - stroke

U2 - 10.3399/bjgp15X685621

DO - 10.3399/bjgp15X685621

M3 - Article

C2 - 26120134

VL - 65

SP - e421-e427

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

IS - 636

ER -