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J Pak Med Assoc. 2016 Feb;66(2):174-8.

Effect of continued professional development on clinical performance in a public sector health care setting.

Author information

1
Community Medicine Department, Army Medical College, Rawalpindi.
2
Community Medicine Department, Rawal Institute of Health Sciences, Islamabad.
3
Community Medicine Department, Biochemistry Department, Foundation University Medical College, Rawalpindi.

Abstract

OBJECTIVE:

To determine the effectiveness of intervention by education of doctors in improving the referral rate and quality in a public-sector healthcare setting.

METHODS:

The quasi-experimental study was conducted from March to September 2012 at PNS Rahat Hospital in naval sailors' residential estate, Karsaz, Karachi. Two awareness sessions were held three months apart by a gynaecologist and a paediatrician. The sessions were aimed at communicating the consultant practice to female general practitioners employed at the two family welfare centres. Pre- and post-intervention data was collected manually from the record registers at the two centers as well as gynaecology and paediatrics outpatient clinics.

RESULTS:

The study comprised 10 female GPs. In paediatric clinic, there was 47% (118 post intervention/ 187 pre intervention) reduction in referrals for acute gastroenteritis and fever of unknown origin (32 post intervention/75 pre intervention). In gynaecology, 30% (50 post intervention/61 pre intervention) reduction was seen in referrals for severe anaemia in 2nd and 3rd trimesters of pregnancy, and an increase in referrals (35 post intervention/19 pre intervention) for high-risk cases indicating better counselling and case identification. Improved standard of counselling was also reflected by 31% reduced referrals (40 post intervention/ 58 pre intervention) for hyper-emesis gravidarum during the first trimester. The difference in referrals was not statistically significant (p>0.05) for paediatrics, but it was highly significant (p<0.001) for gynaecology.

CONCLUSIONS:

Healthcare system can function optimally with focus on referral standards and by improving the communication between the primary care physicians and consultants.

KEYWORDS:

Healthcare system, Referral quality, Continued medical education, Communication.

PMID:
26819163
[Indexed for MEDLINE]
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