Skip to main content
Top
Published in: BMC Primary Care 1/2014

Open Access 01-12-2014 | Study protocol

Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study - protocol of a mixed methods study

Authors: James P Sheppard, Satinder Singh, Janet Jones, Elizabeth Bates, John Skelton, Connie Wiskin, Richard J McManus, Ruth M Mellor

Published in: BMC Primary Care | Issue 1/2014

Login to get access

Abstract

Background

As the first point of contact for patients and witnesses of stroke, General Practice receptionists can be instrumental in deciding the urgency of clinical contact. Despite the considerable complexity of this task, reception staff are not clinically trained. Minimising the time taken to access thrombolysis is crucial in acute stroke as treatment must be initiated within 4.5 hours of the onset, and the earlier the better, to achieve the best outcomes. Research suggests that patients who first contact their General Practice following the onset of stroke symptoms are less likely to receive thrombolysis, in part due to significant delays within Primary Care.
This study therefore aims to understand the role of General Practice receptionists, with particular interest in receptionist’s ability to recognise people who may be suffering from a stroke and to handle such patients as a medical emergency.

Methods

The Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study will be a Primary Care based mixed methods study. 60 General Practices in the West Midlands will be recruited. Each practice will receive 10 unannounced simulated patient telephone calls, after the 10 calls questionnaires will be administered to each receptionist. These will examine the behaviour of receptionists towards patients presenting in Primary Care with stroke symptoms, and their knowledge of stroke symptoms. An embedded qualitative study will use interviews and focus groups to investigate the views of General Practice staff on the receptionists’ role in patient referral and whether training in this area would be helpful.

Discussion

The results of the RECEPTS study will have important implications for providers of Primary Care. The study will establish current practice in UK primary care in terms of General Practice receptionists’ knowledge of the presentation and appropriate referral of those who may be suffering a stroke. It will highlight training needs and how such training might be best delivered.
Appendix
Available only for authorised users
Literature
1.
go back to reference Arber S, Sawyer L: The role of the receptionist in general practice: a ‘dragon behind the desk’?. Soc Sci Med. 1985, 20: 911-921. 10.1016/0277-9536(85)90347-8.CrossRefPubMed Arber S, Sawyer L: The role of the receptionist in general practice: a ‘dragon behind the desk’?. Soc Sci Med. 1985, 20: 911-921. 10.1016/0277-9536(85)90347-8.CrossRefPubMed
2.
go back to reference Gallagher M, Pearson P, Drinkwater C, Guy J: Managing patient demand: a qualitative study of appointment making in general practice. Br J Gen Pract. 2001, 51: 280-285.PubMedPubMedCentral Gallagher M, Pearson P, Drinkwater C, Guy J: Managing patient demand: a qualitative study of appointment making in general practice. Br J Gen Pract. 2001, 51: 280-285.PubMedPubMedCentral
4.
go back to reference Copeman JP, Van Zwanenberg TD: Practice receptionists: poorly trained and taken for granted?. Br J Gen Pract. 1988, 38: 14-16. Copeman JP, Van Zwanenberg TD: Practice receptionists: poorly trained and taken for granted?. Br J Gen Pract. 1988, 38: 14-16.
5.
go back to reference Carnegie MA, Gomel MK, Saunders JB, Britt H, Burns L: General practice receptionists’ attitudes and beliefs towards preventive medicine before and after training and support interventions. Fam Pract. 1996, 13: 504-510. 10.1093/fampra/13.6.504.CrossRefPubMed Carnegie MA, Gomel MK, Saunders JB, Britt H, Burns L: General practice receptionists’ attitudes and beliefs towards preventive medicine before and after training and support interventions. Fam Pract. 1996, 13: 504-510. 10.1093/fampra/13.6.504.CrossRefPubMed
6.
go back to reference Eisner M, Britten N: What do general practice receptionists think and feel about their work?. Br J Gen Pract. 1999, 49: 103-106.PubMedPubMedCentral Eisner M, Britten N: What do general practice receptionists think and feel about their work?. Br J Gen Pract. 1999, 49: 103-106.PubMedPubMedCentral
7.
go back to reference Hammond J, Gravenhorst K, Funnell E, Beatty S, Hibbert D, Lamb J, Burroughs H, Kovandzic M, Gabbay M, Dowrick C, Gask L, Waheed W, Chew-Graham CA: Slaying the dragon myth: an ethnographic study of receptionists in UK general practice. Br J Gen Pract. 2013, 63: e177-e184.CrossRefPubMedPubMedCentral Hammond J, Gravenhorst K, Funnell E, Beatty S, Hibbert D, Lamb J, Burroughs H, Kovandzic M, Gabbay M, Dowrick C, Gask L, Waheed W, Chew-Graham CA: Slaying the dragon myth: an ethnographic study of receptionists in UK general practice. Br J Gen Pract. 2013, 63: e177-e184.CrossRefPubMedPubMedCentral
8.
go back to reference Townsend N, Wickramasinghe K, Bhatnagar P, Smolina K, Nichols M, Leal J, Luengo-Fernandez R, Rayner M: Coronary Heart Disease Statistics. 2012, London: British Heart Foundation, 2012 Townsend N, Wickramasinghe K, Bhatnagar P, Smolina K, Nichols M, Leal J, Luengo-Fernandez R, Rayner M: Coronary Heart Disease Statistics. 2012, London: British Heart Foundation, 2012
9.
10.
go back to reference Wahlgren N, Ahmed N, Davalos A, Hacke W, Millan M, Muir K, Roine RO, Toni D, Lees KR: Thrombolysis with alteplase 3–4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet. 2008, 372: 1303-1309. 10.1016/S0140-6736(08)61339-2.CrossRefPubMed Wahlgren N, Ahmed N, Davalos A, Hacke W, Millan M, Muir K, Roine RO, Toni D, Lees KR: Thrombolysis with alteplase 3–4.5 h after acute ischaemic stroke (SITS-ISTR): an observational study. Lancet. 2008, 372: 1303-1309. 10.1016/S0140-6736(08)61339-2.CrossRefPubMed
11.
go back to reference Saver JL: Time is brain - quantified. Stroke. 2006, 37: 263-266. 10.1161/01.STR.0000196957.55928.ab.CrossRefPubMed Saver JL: Time is brain - quantified. Stroke. 2006, 37: 263-266. 10.1161/01.STR.0000196957.55928.ab.CrossRefPubMed
12.
go back to reference Araujo DV, Teich V, Passos RB, Martins SC: Analysis of the cost-effectiveness of thrombolysis with alteplase in stroke. Arq Bras Cardiol. 2010, 95: 12-20. 10.1590/S0066-782X2010005000067.CrossRefPubMed Araujo DV, Teich V, Passos RB, Martins SC: Analysis of the cost-effectiveness of thrombolysis with alteplase in stroke. Arq Bras Cardiol. 2010, 95: 12-20. 10.1590/S0066-782X2010005000067.CrossRefPubMed
13.
go back to reference Sandercock P, Wardlaw JM, Lindley RI, Dennis M, Cohen G, Murray G, Innes K, Venables G, Czlonkowska A, Kobayashi A, Ricci S, Murray V, Berge E, Slot KB, Hankey GJ, Correia M, Peeters A, Matz K, Lyrer P, Gubitz G, Phillips SJ, Arauz A: The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet. 2012, 379: 2352-2363.CrossRefPubMed Sandercock P, Wardlaw JM, Lindley RI, Dennis M, Cohen G, Murray G, Innes K, Venables G, Czlonkowska A, Kobayashi A, Ricci S, Murray V, Berge E, Slot KB, Hankey GJ, Correia M, Peeters A, Matz K, Lyrer P, Gubitz G, Phillips SJ, Arauz A: The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial [IST-3]): a randomised controlled trial. Lancet. 2012, 379: 2352-2363.CrossRefPubMed
14.
go back to reference Wardlaw JM, Murray V, Berge E, del Zoppo G, Sandercock P, Lindley RL, Cohen G: Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis. Lancet. 2012, 379: 2364-2372. 10.1016/S0140-6736(12)60738-7.CrossRefPubMedPubMedCentral Wardlaw JM, Murray V, Berge E, del Zoppo G, Sandercock P, Lindley RL, Cohen G: Recombinant tissue plasminogen activator for acute ischaemic stroke: an updated systematic review and meta-analysis. Lancet. 2012, 379: 2364-2372. 10.1016/S0140-6736(12)60738-7.CrossRefPubMedPubMedCentral
15.
go back to reference Henssge U, Hoffman A, Kavanagh S, Roughton M, Rudd A, Cloud G, On behalf of the Intercollegiate Stroke Working Party: The National Sentinal Stroke Audit 2010. Round. 2011, 7: 1-74. Ref Type: Report Henssge U, Hoffman A, Kavanagh S, Roughton M, Rudd A, Cloud G, On behalf of the Intercollegiate Stroke Working Party: The National Sentinal Stroke Audit 2010. Round. 2011, 7: 1-74. Ref Type: Report
16.
go back to reference Nasr DM, Brinjikji W, Cloft HJ, Rabinstein AA: Utilization of intravenous thrombolysis is increasing in the United States. Int J Stroke. 2012, 8 (8): 681-688.CrossRefPubMed Nasr DM, Brinjikji W, Cloft HJ, Rabinstein AA: Utilization of intravenous thrombolysis is increasing in the United States. Int J Stroke. 2012, 8 (8): 681-688.CrossRefPubMed
17.
go back to reference Harraf F, Sharma AK, Brown MM, Lees KR, Vass RI, Kalra L: A multicentre observational study of presentation and early assessment of acute stroke. BMJ. 2002, 325: 17-22. 10.1136/bmj.325.7354.17.CrossRefPubMedPubMedCentral Harraf F, Sharma AK, Brown MM, Lees KR, Vass RI, Kalra L: A multicentre observational study of presentation and early assessment of acute stroke. BMJ. 2002, 325: 17-22. 10.1136/bmj.325.7354.17.CrossRefPubMedPubMedCentral
18.
go back to reference Lindsberg PJ, Happola O, Kallela M, Valanne L, Kuisma M, Kaste M: Door to thrombolysis: ER reorganization and reduced delays to acute stroke treatment. Neurology. 2006, 67: 334-336. 10.1212/01.wnl.0000224759.44743.7d.CrossRefPubMed Lindsberg PJ, Happola O, Kallela M, Valanne L, Kuisma M, Kaste M: Door to thrombolysis: ER reorganization and reduced delays to acute stroke treatment. Neurology. 2006, 67: 334-336. 10.1212/01.wnl.0000224759.44743.7d.CrossRefPubMed
19.
go back to reference Lecouturier J, Murtagh MJ, Thomson RG, Ford GA, White M, Eccles M, Rodgers H: Response to symptoms of stroke in the UK: a systematic review. BMC Health Serv Res. 2010, 10: 157-10.1186/1472-6963-10-157.CrossRefPubMedPubMedCentral Lecouturier J, Murtagh MJ, Thomson RG, Ford GA, White M, Eccles M, Rodgers H: Response to symptoms of stroke in the UK: a systematic review. BMC Health Serv Res. 2010, 10: 157-10.1186/1472-6963-10-157.CrossRefPubMedPubMedCentral
20.
go back to reference Jones SP, Jenkinson AJ, Leathley MJ, Watkins CL: Stroke knowledge and awareness: an integrative review of the evidence. Age Ageing. 2010, 39: 11-22. 10.1093/ageing/afp196.CrossRefPubMed Jones SP, Jenkinson AJ, Leathley MJ, Watkins CL: Stroke knowledge and awareness: an integrative review of the evidence. Age Ageing. 2010, 39: 11-22. 10.1093/ageing/afp196.CrossRefPubMed
21.
go back to reference Jones SP, Dickinson HA, Ford GA, Gibson JM, Leathley MJ, McAdam JJ, McLoughlin A, Quinn T, Watkins CL: Callers’ experiences of making emergency calls at the onset of acute stroke: a qualitative study. Emerg Med J. 2012, 29: 502-505. 10.1136/emj.2010.108563.CrossRefPubMed Jones SP, Dickinson HA, Ford GA, Gibson JM, Leathley MJ, McAdam JJ, McLoughlin A, Quinn T, Watkins CL: Callers’ experiences of making emergency calls at the onset of acute stroke: a qualitative study. Emerg Med J. 2012, 29: 502-505. 10.1136/emj.2010.108563.CrossRefPubMed
22.
go back to reference Mackintosh JE, Murtagh MJ, Rodgers H, Thomson RG, Ford GA, White M: Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study. PLoS One. 2012, 7: e46124-10.1371/journal.pone.0046124.CrossRefPubMedPubMedCentral Mackintosh JE, Murtagh MJ, Rodgers H, Thomson RG, Ford GA, White M: Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study. PLoS One. 2012, 7: e46124-10.1371/journal.pone.0046124.CrossRefPubMedPubMedCentral
23.
go back to reference Moloczij N, McPherson KM, Smith JF, Kayes NM: Help seeking at the time of stroke: stroke survivors perspectives on their decisions. Health Soc Care Community. 2008, 16: 501-510. 10.1111/j.1365-2524.2008.00771.x.CrossRefPubMed Moloczij N, McPherson KM, Smith JF, Kayes NM: Help seeking at the time of stroke: stroke survivors perspectives on their decisions. Health Soc Care Community. 2008, 16: 501-510. 10.1111/j.1365-2524.2008.00771.x.CrossRefPubMed
24.
go back to reference Mosley I, Nicol M, Donnan G, Dewey H: Family physician decisions following stroke symptom onset and delay times to ambulance call. BMC Fam Pract. 2011, 12: 82-10.1186/1471-2296-12-82.CrossRefPubMedPubMedCentral Mosley I, Nicol M, Donnan G, Dewey H: Family physician decisions following stroke symptom onset and delay times to ambulance call. BMC Fam Pract. 2011, 12: 82-10.1186/1471-2296-12-82.CrossRefPubMedPubMedCentral
25.
go back to reference Jarrell B, Davis SM, Coyner J, Crocco T, Whiteman C: Primary care office responses to a stroke scenario. W V Med J. 2011, 107 (24): 26-28. Jarrell B, Davis SM, Coyner J, Crocco T, Whiteman C: Primary care office responses to a stroke scenario. W V Med J. 2011, 107 (24): 26-28.
26.
go back to reference Beullens J, Rethans JJ, Goedhuys J, Buntinx F: The use of standardized patients in research in general practice. Fam Pract. 1997, 14: 58-62. 10.1093/fampra/14.1.58.CrossRefPubMed Beullens J, Rethans JJ, Goedhuys J, Buntinx F: The use of standardized patients in research in general practice. Fam Pract. 1997, 14: 58-62. 10.1093/fampra/14.1.58.CrossRefPubMed
27.
go back to reference Grant C, Nicolas R, Moore L, Salisbury C: An observational study comparing quality of care in walk-in centres with general practice and NHS direct using standardised patients. BMJ. 2002, 324: 1556-10.1136/bmj.324.7353.1556.CrossRefPubMedPubMedCentral Grant C, Nicolas R, Moore L, Salisbury C: An observational study comparing quality of care in walk-in centres with general practice and NHS direct using standardised patients. BMJ. 2002, 324: 1556-10.1136/bmj.324.7353.1556.CrossRefPubMedPubMedCentral
28.
go back to reference Campbell JL, Carter M, Davey A, Roberts MJ, Elliott MN, Roland M: Accessing primary care: a simulated patient study. Br J Gen Pract. 2013, 63: e171-e176. 10.3399/bjgp13X664216.CrossRefPubMedCentral Campbell JL, Carter M, Davey A, Roberts MJ, Elliott MN, Roland M: Accessing primary care: a simulated patient study. Br J Gen Pract. 2013, 63: e171-e176. 10.3399/bjgp13X664216.CrossRefPubMedCentral
29.
go back to reference Clarke CE, Edwards J, Nicholl DJ, Sivaguru A, Davies P, Wiskin C: Ability of a nurse specialist to diagnose simple headache disorders compared with consultant neurologists. J Neurol Neurosurg Psychiatry. 2005, 76: 1170-1172. 10.1136/jnnp.2004.057968.CrossRefPubMedPubMedCentral Clarke CE, Edwards J, Nicholl DJ, Sivaguru A, Davies P, Wiskin C: Ability of a nurse specialist to diagnose simple headache disorders compared with consultant neurologists. J Neurol Neurosurg Psychiatry. 2005, 76: 1170-1172. 10.1136/jnnp.2004.057968.CrossRefPubMedPubMedCentral
30.
go back to reference Watson MC, Skelton JR, Bond CM, Croft P, Wiskin CM, Grimshaw JM, Mollison J: Simulated patients in the community pharmacy setting. Using simulated patients to measure practice in the community pharmacy setting. Pharm World Sci. 2004, 26: 32-37.CrossRefPubMed Watson MC, Skelton JR, Bond CM, Croft P, Wiskin CM, Grimshaw JM, Mollison J: Simulated patients in the community pharmacy setting. Using simulated patients to measure practice in the community pharmacy setting. Pharm World Sci. 2004, 26: 32-37.CrossRefPubMed
31.
go back to reference Giesen P, Ferwerda R, Tijssen R, Mokkink H, Drijver R, van den Bosch W, Grol R: Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?. Qual Saf Health Care. 2007, 16: 181-184. 10.1136/qshc.2006.018846.CrossRefPubMedPubMedCentral Giesen P, Ferwerda R, Tijssen R, Mokkink H, Drijver R, van den Bosch W, Grol R: Safety of telephone triage in general practitioner cooperatives: do triage nurses correctly estimate urgency?. Qual Saf Health Care. 2007, 16: 181-184. 10.1136/qshc.2006.018846.CrossRefPubMedPubMedCentral
32.
go back to reference Huibers L, Giesen P, Smits M, Mokkink H, Grol R, Wensing M: Nurse telephone triage in Dutch out-of-hours primary care: the relation between history taking and urgency estimation. Eur J Emerg Med. 2012, 19: 309-315. 10.1097/MEJ.0b013e32834d3e67.CrossRefPubMed Huibers L, Giesen P, Smits M, Mokkink H, Grol R, Wensing M: Nurse telephone triage in Dutch out-of-hours primary care: the relation between history taking and urgency estimation. Eur J Emerg Med. 2012, 19: 309-315. 10.1097/MEJ.0b013e32834d3e67.CrossRefPubMed
33.
go back to reference Blades LL, Oser CS, Dietrich DW, Okon NJ, Rodriguez DV, Burnett AM, Russell JA, Allen MJ, Fogle CC, Helgerson SD, Gohdes D, Harwell TS: Rural community knowledge of stroke warning signs and risk factors. Prev Chronic Dis. 2005, 2: A14-PubMedPubMedCentral Blades LL, Oser CS, Dietrich DW, Okon NJ, Rodriguez DV, Burnett AM, Russell JA, Allen MJ, Fogle CC, Helgerson SD, Gohdes D, Harwell TS: Rural community knowledge of stroke warning signs and risk factors. Prev Chronic Dis. 2005, 2: A14-PubMedPubMedCentral
34.
go back to reference Hickey A, Holly D, McGee H, Conroy R, Shelley E: Knowledge of stroke risk factors and warning signs in Ireland: development and application of the Stroke Awareness Questionnaire (SAQ). Int J Stroke. 2012, 7: 298-306.PubMed Hickey A, Holly D, McGee H, Conroy R, Shelley E: Knowledge of stroke risk factors and warning signs in Ireland: development and application of the Stroke Awareness Questionnaire (SAQ). Int J Stroke. 2012, 7: 298-306.PubMed
35.
go back to reference Pancioli AM, Broderick J, Kothari R, Brott T, Tuchfarber A, Miller R, Khoury J, Jauch E: Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998, 279: 1288-1292. 10.1001/jama.279.16.1288.CrossRefPubMed Pancioli AM, Broderick J, Kothari R, Brott T, Tuchfarber A, Miller R, Khoury J, Jauch E: Public perception of stroke warning signs and knowledge of potential risk factors. JAMA. 1998, 279: 1288-1292. 10.1001/jama.279.16.1288.CrossRefPubMed
36.
go back to reference Parahoo K, Thompson K, Cooper M, Stringer M, Ennis E, McCollam P: Stroke: awareness of the signs, symptoms and risk factors–a population-based survey. Cerebrovasc Dis. 2003, 16: 134-140. 10.1159/000070593.CrossRefPubMed Parahoo K, Thompson K, Cooper M, Stringer M, Ennis E, McCollam P: Stroke: awareness of the signs, symptoms and risk factors–a population-based survey. Cerebrovasc Dis. 2003, 16: 134-140. 10.1159/000070593.CrossRefPubMed
37.
go back to reference Yoon SS, Heller RF, Levi C, Wiggers J, Fitzgerald PE: Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke. 2001, 32: 1926-1930. 10.1161/01.STR.32.8.1926.CrossRef Yoon SS, Heller RF, Levi C, Wiggers J, Fitzgerald PE: Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke. 2001, 32: 1926-1930. 10.1161/01.STR.32.8.1926.CrossRef
38.
go back to reference Richie J: The application of qualitative methods to social research. Qualitative Research Practice: A guide for social science students and researchers. Edited by: Richie J, Lewis J. 2003, London: SAGE, 24-46. Richie J: The application of qualitative methods to social research. Qualitative Research Practice: A guide for social science students and researchers. Edited by: Richie J, Lewis J. 2003, London: SAGE, 24-46.
39.
go back to reference Ritchie J, Spenser L, O’Connor W: Carrying out qualitative analysis. Qualitative Research Practice: A guide for social science students and researchers. Edited by: Ritchie J, Lewis J. 2003, London: SAGE, 219-262. Ritchie J, Spenser L, O’Connor W: Carrying out qualitative analysis. Qualitative Research Practice: A guide for social science students and researchers. Edited by: Ritchie J, Lewis J. 2003, London: SAGE, 219-262.
Metadata
Title
Receptionist rECognition and rEferral of PaTients with Stroke (RECEPTS) study - protocol of a mixed methods study
Authors
James P Sheppard
Satinder Singh
Janet Jones
Elizabeth Bates
John Skelton
Connie Wiskin
Richard J McManus
Ruth M Mellor
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2014
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/1471-2296-15-91

Other articles of this Issue 1/2014

BMC Primary Care 1/2014 Go to the issue