Print Email Facebook Twitter Implementation of a shared care guideline for back pain: Effect on unnecessary referrals Title Implementation of a shared care guideline for back pain: Effect on unnecessary referrals Author Fleuren, M. Dusseldorp, E. van den Bergh, S. Vlek, H. Wildschut, J. van den Akker, E. Wijkel, D. TNO Kwaliteit van Leven Publication year 2010 Abstract Objective: To determine the effect of the implementation of a shared care guideline for the lumbosacral radicular syndrome (LRS) on unnecessary early referrals and the duration of the total diagnostic procedure. Design: Introduction of shared care guideline in November 2005. Pre-test in 2005 (April to October), a first post-test in 2006 (April to October) and a second post-test in 2007 (April to October). Setting and Intervention: The introduction of a shared care guideline derived from national guidelines for GPs and several medical/paramedical specialists in two Dutch regions. Three hundred and sixty GPs, 550 physiotherapists and two hospitals (9 neurologists and 18 radiologists) were involved. The essential component of the guideline was a trade-off: if the GP complied with the conservative management approach in the first 6 weeks, the hospital guaranteed a priority appointment with the neurologist after 6 weeks, if still required. Main Outcome Measures: The neurologists in both hospitals registered whether a patient had been unnecessarily referred during the first 6 weeks. The duration of the total diagnostic procedure was defined as the number of days between referral by the GP and the consultation when the neurologist made the final diagnosis. Results: The percentage of patients being unnecessarily referred within 6 weeks fell significantly from 15% in 2005 to 9% in 2006 and 8% in 2007. The duration of the total diagnostic procedure also fell significantly in both the long and short terms. Conclusions: The introduction of a shared care guideline for all care providers in a region reduces the number of unnecessary early referrals for patients with LRS. © The Author 2010. Published by Oxford University Press in association with the International Society for Quality in Health Care. Subject HealthLeefomgeving en gezondheidGuideline adherenceHospitalsImplementationPrimary health careQuality of health careSciaticaarticlebackacheconservative treatmentdiagnostic proceduregeneral practitionerhealth care costhealth care planninghealth care qualityhealth servicelumbosacral radicular syndromemedical specialistnerve root compressionparamedical personnelpatient referralphysiotherapistpractice guidelinepriority journalradiologistshared care guideline To reference this document use: http://resolver.tudelft.nl/uuid:e480d9e8-bd71-4994-9edb-4fe59e4cb4ef TNO identifier 409822 ISSN 1353-4505 Source International Journal for Quality in Health Care, 22 (5), 415-420 Article number No.: mzq046 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.