Electronic endoscopy referral, particularly via a specific referral form on HealthLink, was identified by triage nurses as an enabler of effective triage, according to a paper published by the HSE endoscopy programme.
The paper was based on a survey of endoscopy triage nurses that explored their experiences to date. In March 2021, funding for 29 clinical nurse manager triage posts was secured by the HSE and 22 were in post in December 2022. Some endoscopy services already had a dedicated triage nurse role.
The overall aim of the role is to improve access to endoscopy services and offer the most appropriate care pathway for patients. During 2022, over 17,000 GI endoscopy referrals were triaged by nurses across 19 hospitals. At least 14 per cent of these patients did not require an invasive procedure, according to the paper.
The 22 nurses recruited under the 2021 funding were invited to participate in the survey and there was a response rate of 73 per cent (n=16).
National clinical guidance and peer support were reported as the two most significant factors in successfully embedding the roles nationwide.
Seventy-five per cent (n=12) of participants reported challenges in their role. Some of these issues related to workload, HealthLink/e-referrals and communication. “Challenges with support of the roll-out of the triage role in individual hospitals was identified throughout the survey. Feedback included difficulty with buy-in to the role of endoscopy nurse-led triage.”
Communication was the most notable theme identified in the survey. “Positive feedback in relation to communication from nurses was reported with 69 per cent (n=11) of respondents commenting that peer support from colleagues in the network group [of endoscopy nurses in triage, pre-assessment and clinical validation] was a valuable resource for advice.”
Challenges relating to communication from GPs were highlighted. This was primarily related to insufficient information on referrals. A suggestion for information to be circulated to GPs on direct access endoscopy, as well as endoscopy referral pathways, was identified.
Many GPs make referrals to endoscopy services using the general referral form on HealthLink, outlined the report.
Since 2018, another more detailed referral form specifically for making endoscopy referrals has been available on HealthLink.
“Referrals made on the specific endoscopy form on HealthLink aid triage nurses in decision making,” stated the report. “While there are some changes to workflows needed for an endoscopy service to accept e-referrals, the added benefits of this referral method are clear to triage nurses, and many are keen to see their endoscopy service accept referrals from GPs that use the specific endoscopy form on HealthLink.”
A spokesperson for the HSE endoscopy programme told the Medical Independent that 26 of the 29 funded posts are now
Currently, 16 public hospitals accept referrals via the endoscopy-specific HealthLink referral form.
The endoscopy programme is commencing a project to review the form and seek the views of stakeholders on any amendments required. “Input from GPs will be sought as part of this project,” said the spokesperson.
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