Current Quality Level of Referral Letters and Feedback Reports in the First Health Cluster in Riyadh Health Cluster Primary Healthcare Centers

Abstract

Background: Effective communication between primary healthcare centers (PHCCs) and referral hospitals is critical for ensuring the continuity and quality of patient care. Referral letters and feedback reports are essential for this communication, yet their quality is often inconsistent, potentially impacting patient outcomes. Study Aim: To assess the standard of feedback reports from referral hospitals and the quality of referral letters from PHCCs within the first health cluster in Riyadh. Methodology: This cross-sectional study randomly selected 360 referral letters and feedback reports from nine PHCCs in the first health cluster in Riyadh. Systematic sampling was employed to select approximately 55 documents from each center. Each document was evaluated based on 16 key components as per the Quality Assurance Manual of the Ministry of Health, using an author-developed scoring system. Results: The study included 360 referral letters and feedback reports, with an average quality score of 13.2 ± 1.5 out of 16. A majority of the documents (253, 70.3%) scored 13 or higher. Key components such as general information and patient file numbers were present in all documents (100%). Vital signs were documented in 351 cases (97.5%), and the reason for referral in 327 cases (90.8%). However, investigation results and current treatment details were included in only 142 (39.4%) and 150 (41.7%) of the documents, respectively. Clear handwriting was observed in 262 reports (72.8%), while 98 (27.2%) had legibility issues. Conclusion: The overall quality of referral letters and feedback reports in the first health cluster in Riyadh is relatively high. However, significant gaps were identified in the documentation of investigation results, current treatment details, and clinical examination findings. Addressing these gaps through targeted training, standardized documentation practices, and the adoption of electronic health records can enhance the quality of patient referrals and improve care continuity and outcomes.