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Standardized Pediatric Urology Referral Guide Increases Satisfaction Among Providers in Primary Care and Specialty Care
Phipps, Shane
Phipps, Shane
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Abstract
Congenital genitourinary abnormalities are common in pediatrics and require timely evaluation to prevent long-term morbidity. Inconsistent or inappropriate referrals to pediatric urology contribute to delayed care, inefficient use of specialty resources, and dissatisfaction among both primary care providers (PCPs) and specialists. Prior studies have demonstrated high rates of unnecessary referrals and low provider confidence related to pediatric urology referral processes. The purpose of this quality improvement project was to develop and implement a standardized, pediatric urology–endorsed referral guide to improve PCP confidence with referrals and increase satisfaction among pediatric urology specialists at a large academic medical center. Drawing from existing guidelines, a comprehensive referral guide was created to address common pediatric urology diagnoses. The guide was designed in collaboration with primary care providers and pediatric urology specialists and included pre-referral workup and recommendation sections. This project also sought to promote a supportive and collaborative environment between providers. PCP confidence improved across all measured domains following guideline implementation. Post-intervention survey respondents reported increased confidence in referral timing, diagnostic testing, physical examination requirements, and initiation of first-line therapies. Referral volume increased slightly from 212 referrals pre-intervention to 223 post-intervention. Post-intervention specialist surveys demonstrated improvement in overall referral appropriateness and satisfaction with referral timing, though dissatisfaction persisted regarding pre-referral physical examinations and diagnostic testing. Overall appropriateness of referrals improved, with all specialists reporting being at least somewhat satisfied. Implementation of a standardized pediatric urology referral guide was associated with improved PCP confidence and modest improvements in specialist satisfaction with referral appropriateness. While referral volume did not decrease, improved clarity and preparedness of referrals suggest enhanced care coordination. These findings support the use of standardized, user-centered referral tools to strengthen interprofessional collaboration and improve specialty access. Ongoing refinement and sustained implementation may further enhance referral quality and provider satisfaction over time.
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2026-05-03
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Phipps_Manuscript_Final .pdf
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- Embargoed until 2028-05-03