Receptionist rECognition and rEferral of Patients with Stroke (RECEPTS)
- 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.
- 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.