A Delphi consensus study

Introduction. Medical letters play an important role in communication between health professionals, and particularly between primary care physicians and hospital emergencies. Relevant information is sometimes missing in referral letters between primary care and hospitals, especially in paediatrics. Objectives. To develop via a Delphi method, a referral letter for paediatric emergencies, defining its useful content and format. Method. Our group was initially composed of local general practitioners (13), liberal pediatricians (3) and SOS practitioners (3), as well as care workers (9 nurses and 9 doctors) of HFME ("Hopital Femme-Mere- Enfant") in Bron, "Hospices civils de Lyon". Results. On 35 initial items on the referral letter, 33 made immediate consensus in the first round. Six items were submitted for the second round (2 new and 4 reworded/modified), they all made consensus, then. Conclusion. We obtained a consensus between primary care physicians and hospital care workers on the characteristics of a referral letter to a paediatric emergencies ward. From this consensus, we elaborated a fillable template letter which could be used daily for the referral (or regulation) of a patient to the emergencies ward of HFME. Further studies are required to assess the impact of this new template for a referral letter on the quality criteria of the received referral letters and on the patient medical care.