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Referral management centres as a means of reducing outpatients attendances: how do they work and what influences successful implementation and perceived effectiveness?

Overview of attention for article published in BMC Family Practice, March 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#50 of 1,342)
  • High Attention Score compared to outputs of the same age (93rd percentile)

Mentioned by

news
1 news outlet
twitter
36 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
2 Dimensions

Readers on

mendeley
35 Mendeley
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Title
Referral management centres as a means of reducing outpatients attendances: how do they work and what influences successful implementation and perceived effectiveness?
Published in
BMC Family Practice, March 2016
DOI 10.1186/s12875-016-0434-y
Pubmed ID
Authors

Sarah L. Ball, Joanne Greenhalgh, Martin Roland

Abstract

The rising volume of referrals to secondary care is a continuing concern in the NHS in England, with considerable resource implications. Referral management centres (RMCs) are one of a range of initiatives brought in to curtail this rise, but there is currently limited evidence for their effectiveness, and little is known about their mechanisms of action. This study aimed to gain a better understanding of how RMCs operate and the factors contributing to the achievement of their goals. Drawing on the principles of realist evaluation, we sought to elicit programme theories (the ideas and assumptions about how a programme works) and to identify the key issues to be considered when establishing or evaluating such schemes. Qualitative study with a purposive sample of health professionals and managers involved in the commissioning, set-up and running of four referral management centres in England and with GPs referring through these centres. Semi-structured interviews were conducted with 18 participants. Interviews were audio-recorded and transcribed. Data were analysed thematically. Interview data highlighted the diverse aims and functions of RMCs, reflecting a range of underlying programme theories. These included the overarching theory that RMCs work by ensuring the best use of limited resources and three sub-theories, relating to how this could be achieved, namely, improving the quality of referrals and patient care, reducing referrals, and increasing efficiency in the referral process. The aims of the schemes, however, varied between sites and between stakeholders, and evolved significantly over time. Three themes were identified relating to the context in which RMCs were implemented and managed: the impact of practical and administrative difficulties; the importance and challenge of stakeholder buy-in; and the dependence of perceived effectiveness on the aims and priorities of the scheme. Many RMCs were described as successful by those involved, despite limited evidence of reduced referrals or cost-savings. The findings of this study have a number of implications for the development of similar schemes, with respect to the need to ensure clarity of aims and to identify indicators of success from the outset, to anticipate scheme evolution and plan for potential changes with respect to IT systems and referral processes. Also identified, is the need for further research that evaluates the effectiveness and cost effectiveness of particular models of RMC.

Twitter Demographics

The data shown below were collected from the profiles of 36 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 35 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 35 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 34%
Unspecified 7 20%
Researcher 4 11%
Student > Postgraduate 3 9%
Student > Bachelor 3 9%
Other 6 17%
Readers by discipline Count As %
Medicine and Dentistry 11 31%
Nursing and Health Professions 8 23%
Unspecified 7 20%
Social Sciences 4 11%
Business, Management and Accounting 3 9%
Other 2 6%

Attention Score in Context

This research output has an Altmetric Attention Score of 29. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 30 August 2018.
All research outputs
#569,515
of 13,444,601 outputs
Outputs from BMC Family Practice
#50
of 1,342 outputs
Outputs of similar age
#17,797
of 266,265 outputs
Outputs of similar age from BMC Family Practice
#1
of 1 outputs
Altmetric has tracked 13,444,601 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,342 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.4. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 266,265 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them