A Descriptive Analysis of GP Referrals to a Model 4 Emergency Department in the West of Ireland

Abstract Background General Practitioner (GP) referrals to Emergency Departments (EDs) are common in Ireland, yet the structure and content of referral letters in Ireland are poorly described. Understanding these patterns may highlight opportunities to optimise communication and streamline patient flow. Aim The aim of the study was to describe the characteristics, timing, reasons, and content of GP referral letters to a model 4 emergency department, and to identify areas for improvement for GP to ED communication. Methods A retrospective observational study was conducted at University Hospital Galway, a Model 4 ED, analysing all electronic GP referral letters submitted via Healthlink during a two-week period in October 2024. Letters were anonymised, and data on demographics, referral content, and specific requests were extracted. Descriptive statistics and chi-square analysis were performed using SPSS v29. Results Of 654 GP referrals reviewed, 644 were eligible for analysis. Most referrals originated within 5 km of the hospital (42%) and presented during working hours (84%). A likely diagnosis was present in 36%, a specific request in 43%, and vital signs in 60% of letters. Imaging (34%) and specialty review (31%) were the most frequent requests. The most common referral themes were injuries (13%), abdominal pain (12%), and infections (8%). Conclusion Many GP referrals to this model 4 ED requested imaging or request for a review by a specialty. Documentation within letters was varied. Engaging GPs and highlighting key clinical details could improve documentation and, in turn, improve communication and patient disposition.