E019 Rheum for Improvement: an audit of the electronic referral system and referral quality of the rheumatology department, Glasgow Royal Infirmary, NHS Greater Glasgow and Clyde from 7th August 2024-31st October 2024

Background/Aims Glasgow Royal Infirmary is a hospital of the NHS Greater Glasgow and Clyde Trust, with the Rheumatology department an integral part of the same. The aim of this study is to determine the benefit of having an electronic referral system for governance purposes, the quality of information provided within these referrals, and whether there is a documented referral outcome/diagnosis or differential diagnosis identified. Methods Data collation was completed on 14th November 2024 and included all electronic system referrals made from 7th August 2024 to 31st October 2024 inclusive. Strict inclusion criteria were established, including that the referring doctor was currently working in the Glasgow Royal Infirmary catchment area, the referral was made via the electronic referral system on TrakCare TM, and did not include rheumatological emergencies out of hours that would have been dealt with by the out-of-hours medical team accordingly, with advice provided in-hours the next day. Results Data collation yielded 123 referrals made via the electronic referral system to the rheumatology service, with 38.2% of referrals requesting advice, 60.16% of referrals requesting a patient review and 1.63% of referrals requesting the patient to be taken over by the rheumatology department. The most common referral was for an erythematous/synovitic joint with no differential diagnosis attached, while 11.38% of referrals requested a joint aspiration of some kind. 30.89% of referrals did not include examination findings, and 69.10% of referrals did not document any further investigations outside haematological/radiological ones. However, 53.65% of referrals included no documentation of the resident on-call doctor’s differential diagnosis/diagnosis. Conclusion The results illustrated the need for continued education around acute presentations of common rheumatological conditions for referring doctors, as well as ongoing education for rotating resident doctors. It highlighted the benefit of having an electronic referral system and called into question whether an integrated online system, to reduce the workload of duplication of documentation, could be the answer. Disclosure D. Donegan: None. T. Hughes: None. S. Maunick: None. D. McCarey: None.