Referral of children for heart defect or murmur assessment – the quality of referrals needs to be improved

Background The TAUH (Tampere University Hospital) Paediatric Cardiology Clinic receives many referrals for heart defect and murmur assessment. Not all of them meet the referral criteria. Insufficient information makes it difficult to determine the urgency of the referral.

Methods All the referrals for heart defect and murmur assessment received by the TAUH Paediatric Cardiology Clinic during 2017–2018 were analysed and their quality was assessed. Descriptive analysis of the data was performed.

Results There were 490 referrals meeting the inclusion criteria of our study, most of which (72%) were from primary care. Median age of the patients was 2.6 years. The most common reason for a referral was a heart murmur (94%). In 27% of the referrals the information was adequate.

Conclusions Referral guidelines need to be clarified so that referrals contain sufficient information to justify admission for echocardiography or to provide a consultation response. Additional teaching on auscultation and examination of heart murmurs is also needed. Further guidance on referral issues is needed as many referrals do not meet the referral criteria.