Effect of continued professional development on clinical performance in a public sector health care setting

Objective: to determine the effectiveness of intervention by education of doctors in improving the referral rate and quality in a public-sector healthcare setting. methods: the quasi-experimental study was conducted from march to september 2012 at pns rahat hospital in naval sailors' residential estate,karsaz,karachi. two awareness sessions were held three months apart by a gynaecologist and a paediatrician. the sessions were aimed at communicating the consultant practice to female general practitioners employed at the two family welfare centres. pre- and post-intervention data was collected manually from the record registers at the two centers as well as gynaecology and paediatrics outpatient clinics. results: the study comprised 10 female gps. in paediatric clinic,there was 47% (118 post intervention/ 187 pre intervention) reduction in referrals for acute gastroenteritis and fever of unknown origin (32 post intervention/75 pre intervention). in gynaecology,30% (50 post intervention/61 pre intervention) reduction was seen in referrals for severe anaemia in 2nd and 3rd trimesters of pregnancy,and an increase in referrals (35 post intervention/19 pre intervention) for high-risk cases indicating better counselling and case identification. improved standard of counselling was also reflected by 31% reduced referrals (40 post intervention/ 58 pre intervention) for hyper-emesis gravidarum during the first trimester. the difference in referrals was not statistically significant (p>0.05) for paediatrics,but it was highly significant (p<0.001) for gynaecology. conclusion: healthcare system can function optimally with focus on referral standards and by improving the communication between the primary care physicians and consultants. © 2016,pakistan medical association. all rights reserved.