Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS)

West MidlandsStroke
Published Date: 1 Nov 2015

Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS)

Background 

  • Stroke is a leading cause of morbidity and mortality. 
  • Thrombolysis can reduce the burden of stroke, but timely recognition and referral are essential. 
  • The GP is the first point of contact for 22-56% of patients with stroke, but only 55-71% of these are correctly referred. 
  • Most calls are answered by GP receptionists who must determine the urgency and when an appointment should be made. 
  • Common symptoms of stroke include Facial asymmetry, Arm weakness, or slurred Speech (FAST symptoms of anterior stroke); and vertigo, visual disturbance or vomiting (symptoms of posterior stroke).  
  • This study used trained role players to make unannounced simulated patient telephone calls to receptionists (ten vignettes designed to include a range of presentations, categorised by difficulty), and examined individual knowledge via a questionnaire.

Findings

  • 520 simulated calls were made to 52 practices.
  • 69% of calls were referred for immediate response, with 61% being told to call the emergency medical services. 
  • ‘Difficult’ and ‘moderate’ calls were less likely to be immediately referred, compared to ‘easy’ calls.  When the term “stroke” was used, most (93%) responses were for immediate referral, regardless of difficultly. 
  • Calls with fewer/no FAST symptoms were less likely to be immediately referred, compared to those with three FAST symptoms. 
  • Results from questionnaires showed that 96% of receptionists could name at least one symptom of anterior stroke and 73% could name all three FAST symptoms. 
  • However, only 29% reported a common symptom of posterior stroke, and incorrect symptoms were reported by 40% of receptionists. 
  • Only 14% of receptionists reported receiving training related to stroke.
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