Purpose: An oncology nutrition referral priority rating system (NRPRS) was developed and evaluated as a tool to classify patients into nutrition risk categories and allocate reasonable wait times.
Methods: A retrospective chart audit (n=112), patient focus groups (n=14), and a prospective chart audit (n=179) were conducted to refine the tool. Using the NRPRS, the dietitians assigned a priority rating from the information on the referral and then compared it with a second rating after the first visit. Education to referring staff was provided to improve the completeness of referrals.
Results: Patients rated at highest nutrition risk (priorities 1 and 2 [P1 and P2]) had a rating similar to the dietitian's after the first visit (P1, 97%; P2, 84%). Incomplete referrals were assigned a P3 rating. This may explain the discrepancy in ratings for P3 referrals (64%). After education, essential information on the referral form increased by 26%.
Conclusions: The NRPRS is an effective tool for prioritizing high-risk patients when referrals are completed fully. The next step is to validate the NRPRS now that computerized order entry is implemented in the cancer clinic.
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