[Hardly any objection from patients against medical information feedback among healthcare workers in the acute care]. / Nauwelijks bezwaar van SEH-patiënten tegen terugkoppeling medische gegevens.

OBJECTIVE: Feedback of patients' medical information among healthcare workers within the acute care could improve the quality of care during an Emergency Department (ED) visit. However, in practice, feedback among healthcare workers leads to juridical discussions. Therefore, this study explores whether ED patients agree with medical information feedback among healthcare workers in the acute care, such as the ambulance staff and ED physicians, and whether this was different from permission for feedback to the general practitioner. METHOD: Multicenter cross-sectional study in three EDs in the Netherlands. Patients ≥18 years old, presented per ambulance between May 3rd and June 12th 2021, filled in a questionnaire asking whether they agree with medical information feedback to ambulance staff and reviewing medical files for follow-up by ED physicians. RESULTS: A total of 369 patients were included with a mean age of 68 years (SD 18). In total, 98,9% of patients agreed with medical information feedback to ambulance staff, which was not significantly different from the 99,2% of patients who agreed with feedback to the general practitioner (p=1.00). CONCLUSION: All but a few ED patients agreed with medical information exchange to ambulance personnel and follow-up by ED-physicians. During ED-visits, medical information feedback to the general practitioner is a standard procedure, with the possibility of an opt-out. In our opinion, feedback and exchange of medical information within the acute care should be arranged similarly.

Recognition of sepsis in primary care: a survey among GPs.

BACKGROUND: Early recognition and treatment of sepsis are important to reduce morbidity and mortality. Screening tools using vital signs are effective in emergency departments. It is not known how the decision to refer a patient to the hospital with a possible serious infection is made in primary care. AIM: To gain insight into the clinical decision-making process of GPs in patients with possible sepsis infections. DESIGN & SETTING: Survey among a random sample of 800 GPs in the Netherlands. METHOD: Quantitative questionnaire using Likert scales. RESULTS: One hundred and sixty (20.3%) of questionnaires were eligible for analysis. Based on self-reported cases of possible serious infections, the factors most often indicated as important for the decision to refer patients to the hospital were: general appearance (94.1%), gut feeling (92.1%), history (92.0%), and physical examination (89.3%). Temperature (88.7%), heart rate (88.7%), and blood pressure (82.1%), were the most frequently measured vital signs. In general, GPs more likely referred patients in case of: altered mental status (98.7%), systolic blood pressure <100 mmHg (93.7%), unable to stand (89.3%), insufficient effect of previous antibiotic treatment (87.4%), and respiratory rate ≥22/minute (86.1%). CONCLUSION: The GPs' assessment of patients with possible serious infection is a complex process, in which besides checking vital signs, many other aspects of the consultation guide the decision to refer a patient to the hospital. To improve care for patients with sepsis, the diagnostic and prognostic value of assessing the vital signs and symptoms, GPs' gut feeling, and additional diagnostic tests, should be prospectively studied in the primary care setting.