Lessons from a web-based referral system for acute neurosurgical referrals. Part 1: System features and evaluation

Abstract

Background

The implementation of electronic referral systems in healthcare has streamlined communication between referrers and specialists, improving efficiency and documentation. Such systems can optimise patient care and reduce the burden on medical staff. This study reports on the development, implementation, and evaluation of the “Hospital Emergency Neurosurgical Referral Interface” (HENRI), a bespoke web-based referral system introduced at the Royal Brisbane and Women’s Hospital (RBWH).

Methods

HENRI was developed by integrating with existing hospital systems for patient data retrieval. It was gradually implemented, and mandatory use was introduced in 2021. Surveys were conducted before and after HENRI’s implementation to assess user satisfaction. Phone call volumes to neurosurgical registrars were compared pre-HENRI and post-HENRI.

Results

In its first year of use, HENRI handled 3971 referrals for 3065 patients from 1369 referrers at 37 hospitals. The mean time to decision was 1 h and 41 min. A survey post-implementation revealed improved user satisfaction with the referral process, despite concerns about response times and loss of nuanced communication. Phone call analysis showed a 35 % reduction in calls to neurosurgical registrars post-HENRI implementation (p < 0.001).

Conclusions

HENRI has improved documentation, communication, and the efficiency of neurosurgical referrals at RBWH. The reduction in phone calls and streamlined processes have relieved pressure on on-call staff and improved overall patient care. Despite some challenges, including delays in response times and the need for ongoing system refinement, HENRI has proven to be a valuable tool in enhancing neurosurgical referral processes. Future improvements could further optimize its functionality and user experience.