Improving Inpatient Referrals at Withybush Hospital
Referral time cut from 22.5 minutes to under 1 minute
Setting: Withybush General Hospital, Hywel Dda University Health Board (NHS Wales)
Source: Quality Improvement Project, Dr Vasishta et al., 2024
Method: Comparative study — CAREFUL digital referrals vs paper "white slip" system
The problem
Inpatient referrals at Withybush relied on paper "white slips" — a form filled by hand, delivered physically, and filed in the patient notes. The process was slow, error-prone and difficult to track. Clinicians had no way to know whether a referral had been received, accepted or acted upon.
What was measured
The QIP compared the traditional paper referral pathway with CAREFUL's digital referral workflow for cardiology referrals. Clinicians were surveyed on time, safety, efficiency and preference.
Results
- Referral time cut from 22.5 minutes to under 1 minute — a 95% reduction
- 81% of clinicians said CAREFUL promotes patient safety (vs 3% for paper)
- 76% rated CAREFUL as efficient (vs 13% for paper)
- 71% said CAREFUL improves communication between referring and receiving teams
- Clear audit trail replaced untraceable paper slips
The digital referral creates a structured record visible to both sending and receiving teams. Any team member can view the referral status, add to the conversation thread, or accept and reject. Push notifications replace bleeps and phone calls.
Why it matters
Referrals are where patients fall between teams. A paper slip can be lost. A bleep can go unanswered. A phone call leaves no record. CAREFUL makes the referral visible, trackable and accountable — from the moment it is sent to the moment it is completed.