Impact of altering referral threshold from out-of-hours primary care to hospital on patient safety and further health service use: a cohort study.

Ellen Rabben Svedahl; Kristine Pape; Bjarne Austad; Gunnhild Åberge Vie; Kjartan Sarheim Anthun; Fredrik Carlsen; Neil M Davies; Johan Håkon Bjørngaard

Study

Impact of altering referral threshold from out-of-hours primary care to hospital on patient safety and further health service use: a cohort study.

January 11, 2023

Svedahl ER, Pape K, Austad B, et al. BMJ Qual Saf. 2023;32(6):330-340.

View more articles from the same authors.

Inappropriate referrals and unnecessary hospital admissions are ongoing patient safety problems. This cohort study set in Norway examined the impact of emergency physician referral thresholds from out-of-hours services on patient outcomes.

PubMed citation

Available at

Related Resources From the Same Author(s)

Missed acute coronary syndrome during telephone triage at out-of-hours primary care: lessons from a case-control study.

February 3, 2021

Inpatient patient safety events in vulnerable populations: a retrospective cohort study.

November 18, 2020

Associations between internet-based patient ratings and conventional surveys of patient experience in the English NHS: an observational study.

July 11, 2012

Organisation and characteristics of out-of-hours primary care during a COVID-19 outbreak: a real-time observational study.

September 30, 2020

Concordance with urgent referral guidelines in patients presenting with any of six ‘alarm’ features of possible cancer: a retrospective cohort study using linked primary care records.

August 10, 2022

Nurse staffing, nursing assistants and hospital mortality: retrospective longitudinal cohort study.

January 9, 2019

Impact of structured interdisciplinary bedside rounding on patient outcomes at a large academic health centre.

July 22, 2020

How safe are paediatric emergency departments? A national prospective cohort study.

August 3, 2022

Prevalence and characterisation of diagnostic error among 7-day all-cause hospital medicine readmissions: a retrospective cohort study.

September 16, 2020

Evaluating the safety of mental health-related prescribing in UK primary care: a cross-sectional study using the Clinical Practice Research Datalink (CPRD).

September 15, 2021

Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study.

December 23, 2020

Impact of medical education on patient safety: finding the signal through the noise.

February 8, 2023

Patient harm and institutional avoidability of out-of-hours discharge from intensive care: an analysis using mixed methods.

March 23, 2022

Out of sight, out of mind: a prospective observational study to estimate the duration of the Hawthorne effect on hand hygiene events.

November 11, 2020

Safety implications of remote assessments for suspected COVID-19: qualitative study in UK primary care.

March 23, 2022

Impact of smart pump-electronic health record interoperability on patient safety and finances at a community hospital

August 25, 2021

Outcome differences between surgeons performing first and subsequent coronary artery bypass grafting procedures in a day: a retrospective comparative cohort study.

June 29, 2022

Diagnostic trajectories in primary care at 12 months: an observational cohort study.

June 15, 2022

Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review.

December 16, 2020

Impact of unacceptable behaviour between healthcare workers on clinical performance and patient outcomes: a systematic review.

February 16, 2022

Patient feedback for safety improvement in primary care: results from a feasibility study.

July 29, 2020

Chronic hospital nurse understaffing meets COVID-19: an observational study.

September 9, 2020

Timeout procedure in paediatric surgery: effective tool or lip service? A randomised prospective observational study.

March 24, 2021

Impact of full personal protective equipment on alertness of healthcare workers: a prospective study.

February 2, 2022

Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review.

November 28, 2018

National cross-sectional cohort study of the relationship between quality of mental healthcare and death by suicide.

June 1, 2022

Preventable deaths due to problems in care in English acute hospitals: a retrospective case record review study.

August 1, 2012

How do hospital inpatients conceptualise patient safety? A qualitative interview study using constructivist grounded theory.

October 19, 2022

Fall prevention implementation strategies in use at 60 United States hospitals: a descriptive study.

December 9, 2020

Factors that affect opioid quality improvement initiatives in primary care: insights from ten health systems.

December 14, 2022

Unacceptable behaviours between healthcare workers: just the tip of the patient safety iceberg.

June 15, 2022

Emotional safety is patient safety.

February 15, 2023

February 2, 2022

Barcode medication administration technology use in hospital practice: a mixed-methods observational study of policy deviations.

August 4, 2021

Safe clinical practice for patients hospitalised in mental health wards during a suicidal crisis: qualitative study of patient experiences.

December 23, 2020

Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study.

December 2, 2020

Examination of impact of after-hours admissions on hospital resource use, patient outcomes, and costs.

January 11, 2023

Peers without fears? Barriers to effective communication among primary care physicians and oncologists about diagnostic delays in cancer.

November 1, 2017

Higher incidence of adverse events in isolated patients compared with non-isolated patients: a cohort study.

November 18, 2020

Putting out fires: a qualitative study exploring the use of patient complaints to drive improvement at three academic hospitals.

July 10, 2019

Use and impact of virtual primary care on quality and safety: The public's perspectives during the COVID-19 pandemic.

January 12, 2022

User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study.

July 29, 2020

Psychometric properties of the Hospital Survey on Patient Safety Culture: findings from the UK.

May 5, 2010

Work effort, readability and quality of pharmacy transcription of patient directions from electronic prescriptions: a retrospective observational cohort analysis.

March 31, 2021

A realist synthesis of pharmacist-conducted medication reviews in primary care after leaving hospital: what works for whom and why?

December 2, 2020

Exploration of prescribing error reporting across primary care: a qualitative study.

April 13, 2022

A system-wide approach to explaining variation in potentially avoidable emergency admissions: national ecological study.

January 8, 2014

Nursing implications of an early warning system implemented to reduce adverse events: a qualitative study.

May 11, 2022

Use of patient complaints to identify diagnosis-related safety concerns: a mixed-method evaluation.

March 3, 2021

The impact of meaningful use and electronic health records on hospital patient safety.

November 2, 2022

Transmission of community- and hospital-acquired SARS-CoV-2 in hospital settings in the UK: a cohort study.

November 10, 2021

How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience.

February 5, 2020

Factors associated with potentially missed acute deterioration in primary care: cohort study of UK general practices.

October 20, 2021

Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis.

July 8, 2020

Cohort study of diagnostic delay in the clinical pathway of patients with chronic wounds in the primary care setting.

December 14, 2022

National improvements in resident physician-reported patient safety after limiting first-year resident physicians' extended duration work shifts: a pooled analysis of prospective cohort studies.

May 25, 2022

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study.

October 21, 2020

Time out! Rethinking surgical safety: more than just a checklist.

April 28, 2021

Experience of hospital-initiated medication changes in older people with multimorbidity: a multicentre mixed-methods study embedded in the OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people (OPERAM) trial.

December 7, 2022

From fable to reality at Parkland Hospital: the impact of evidence-based design strategies on patient safety, healing, and satisfaction in an adult inpatient environment.

February 10, 2021

Core competencies for patient safety research: a cornerstone for global capacity strengthening.

February 2, 2011

Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme.

June 22, 2022

Challenges and strategies for patient safety in primary care: a qualitative study.

September 28, 2022

Applying thematic synthesis to interpretation and commentary in epidemiological studies: identifying what contributes to successful interventions to promote hand hygiene in patient care.

September 9, 2020

Prospective validation of classification of intraoperative adverse events (ClassIntra): international, multicentre cohort study.

October 7, 2020

The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour and improve safety.

May 5, 2021

20 years after To Err Is Human: a bibliometric analysis of ‘the IOM report’s’ impact on research on patient safety.

January 26, 2022

Interdisciplinary collaboration across secondary and primary care to improve medication safety in the elderly (The IMMENSE study) - a randomized controlled trial.

November 30, 2022

Exploring the impact of employee engagement and patient safety.

September 14, 2022

Impact of teamwork and communication training interventions on safety culture and patient safety in emergency departments: a systematic review.

January 26, 2022

Effects of a refined evidence-based toolkit and mentored implementation on medication reconciliation at 18 hospitals: results of the MARQUIS2 study.

May 19, 2021

Publication of inspection frameworks: a qualitative study exploring the impact on quality improvement and regulation in three healthcare settings.

October 6, 2021

Use of e-triggers to identify diagnostic errors in the paediatric ED.

April 6, 2022

Evaluating the impact of radio frequency identification retained surgical instruments tracking on patient safety: literature review.

August 18, 2021

Effect of contextual factors on the prevalence of diagnostic errors among patients managed by physicians of the same specialty: a single-centre retrospective observational study.

February 8, 2023

Surgeons and systems working together to drive safety and quality.

March 29, 2023

The impact of drug error reduction software on preventing harmful adverse drug events in England: a retrospective database study.

August 24, 2022

Use of an electronic clinical decision support system in primary care to assess inappropriate polypharmacy in young seniors with multimorbidity: observational, descriptive, cross-sectional study

April 8, 2020

The impact of health information management professionals on patient safety: a systematic review.

December 22, 2021

Health literacy-related safety events: a qualitative study of health literacy failures in patient safety events.

July 28, 2021

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents.

May 10, 2017

Unintended consequences of health care reform: impact of changes in payor mix on patient safety indicators,

October 7, 2020

The impact of health system membership on patient safety initiatives.

January 9, 2008

Special Issue on Simulation.

June 5, 2013

The critical role of health information technology in the safe integration of behavioral health and primary care to improve patient care.

November 10, 2021

The impact of the built environment on patient falls in hospital rooms: an integrative review.

June 16, 2021

Providing feedback following Leadership WalkRounds is associated with better patient safety culture, higher employee engagement and lower burnout.

October 25, 2017

Variation in the reporting of elective surgeries and its influence on patient safety indicators.

July 6, 2022

Changing hospital organisational culture for improved patient outcomes: developing and implementing the Leadership Saves Lives intervention.

August 12, 2020

Impact of opioid administration in the intensive care unit and subsequent use in opioid-naïve patients.

June 9, 2021

Trauma Resuscitation Using in situ Simulation Team Training (TRUST) study: latent safety threat evaluation using framework analysis and video review.

September 1, 2021

Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology.

August 5, 2020

When doctors share visit notes with patients: a study of patient and doctor perceptions of documentation errors, safety opportunities and the patient–doctor relationship.

June 15, 2016

Urgent referrals from primary care to dermatology for lesions suspicious for skin cancer: patterns, outcomes, and need for systems improvement.

December 7, 2022

Action on patient safety can reduce health inequalities.

April 13, 2022

Healthcare worker serious safety events: applying concepts from patient safety to improve healthcare worker safety.

August 4, 2021

Effect of the surgical safety checklist on provider and patient outcomes: a systematic review.

April 27, 2022

The impact of the use of employee functional flexibility on patient safety.

November 18, 2020

Association of open communication and the emotional and behavioural impact of medical error on patients and families: state-wide cross-sectional survey.

February 12, 2020

Improving patient handovers from hospital to primary care: a systematic review.

October 3, 2012

Related Resources

Family conferences to facilitate deprescribing in older outpatients with frailty and with polypharmacy: the COFRAIL cluster randomized trial.

May 10, 2023

May 3, 2023

Annual Perspective

Improving Diagnostic Safety and Quality

April 26, 2023

Early diagnosis of cancer: systems approach to support clinicians in primary care.

April 5, 2023

Association between opioid tapering and subsequent health care use, medication adherence, and chronic condition control.

March 1, 2023

Effect of prescriber notifications of patient’s fatal overdose on opioid prescribing at 4 to 12 months: a randomized clinical trial.

January 18, 2023

Medication use evaluation of high-dose long-term opioid de-prescribing in multiple Veterans Affairs medical centers.

January 18, 2023

How timely is diagnosis of lung cancer? Cohort study of individuals with lung cancer presenting in ambulatory care in the United States.

January 11, 2023

Balancing safety, comfort, and fall risk: an intervention to limit opioid and benzodiazepine prescriptions for geriatric patients.

January 11, 2023

Cohort study of diagnostic delay in the clinical pathway of patients with chronic wounds in the primary care setting.

December 14, 2022

Performance of 3 sets of criteria for potentially inappropriate prescribing in older people to identify inadequate drug treatment.

December 14, 2022

Perspective

Primary Care and Patient Safety: Opportunities at the Interface

September 28, 2022

Perspective

In Conversation With... Freya Spielberg, MD, MPH

September 28, 2022

Interview

In Conversation With... Jack Westfall, MD, MPH

September 28, 2022

Concordance with urgent referral guidelines in patients presenting with any of six ‘alarm’ features of possible cancer: a retrospective cohort study using linked primary care records.

August 10, 2022

Annual Perspective

Patient Safety in the Ambulatory Care Setting

August 5, 2022

Long-term risk of overdose or mental health crisis after opioid dose tapering.

July 13, 2022

The Joint Commission's new and revised workplace violence prevention standards for hospitals: a major step forward toward improved quality and safety.

May 4, 2022

How Discrimination in Health Care Affects Older Americans, and What Health Systems and Providers Can Do.

May 4, 2022

Potentially harmful medication dispenses after a fall or hip fracture: a mixed methods study of a commonly used quality measure.

March 9, 2022

Patient safety when receiving telephone advice in primary care - a Swedish qualitative interview study.

February 23, 2022

Improving medical residents’ self-assessment of their diagnostic accuracy: does feedback help?

February 2, 2022

Learning from diagnostic errors to improve patient safety when GPs work in or alongside emergency departments: incorporating realist methodology into patient safety incident report analysis.

January 12, 2022

Safer prescribing and care for the elderly (SPACE): cluster randomised controlled trial in general practice.

December 15, 2021

Impact of state nurse practitioner regulations on potentially inappropriate medication prescribing between physicians and nurse practitioners: a national study in the United States.

December 8, 2021

Assessment of requests for medication-related follow-up after hospital discharge, and the relation to unplanned hospital revisits, in older patients: a multicentre retrospective chart review.

December 8, 2021

Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise patient-reported breakdowns related to the diagnostic process in ambulatory care.

October 27, 2021

Medication reconciliation in the geriatric unit: impact on the maintenance of post-hospitalization prescriptions.

October 13, 2021

Use of heuristics during the clinical decision process from family care physicians in real conditions.

October 6, 2021

Strengths and weaknesses in the diagnostic process of endometriosis from the patients' perspective: a focus group study.

September 15, 2021

See More About The Topic

Ambulatory Clinic or Office

Health Care Executives and Administrators

Policy Makers

Primary Care

Geriatrics

Impact of altering referral threshold from out-of-hours primary care to hospital on patient safety and further health service use: a cohort study.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Impact of altering referral threshold from out-of-hours primary care to hospital on patient safety and further health service use: a cohort study.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

PSNet Log in

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site