Theory based steps | In this case |
---|---|
1. Select target area | |
Frequency | Large patient population [1], referral letters used whenever need for specialised health care. |
Importance | Large suffering, large impact on society [1] |
Complexity | Many stakeholders, inter-organisational |
Insufficiently effective, efficient, accessible, acceptable/patient-centred, equitable, and/or safe care [28] | Risk of incorrect prioritisation of patients and inappropriate care [7, 8] |
Expected improvement potential [13] | Studies reveal that referral letters in general and within mental health care lack important information [4–6] |
2. Determine/define recommended practice | |
Explore existing knowledge [13] | Literature review revealed no evidence-based recommended standard for content of referral letters to specialised mental health care |
If not sufficient knowledge: Define recommended practice | Structured group interview using the method Language Processing [20] |
A. Involve valid perspectives [9]: | Including: |
Professional | Health professionals from primary care (GPs and mental health nurses) and from specialist mental health care (psychiatrist and trained psychologists) |
Patient/client | Patient representatives from Mental Health Patient Organisation |
Organisational | Operating managers within specialist mental health care. |
B. Make feasible [13] | Delphi process to determine the most important content. Exclusion of themes where less than 75% of participants have rated them as highly important [22]. |