Journal of the British Society of Special Care Dentistry
April 2026
Volume: 26
Issue: 2
DOI: 10.63507/ROBM6203
Title: Assessing appropriate triaging for domiciliary referrals: a clinical audit
Author: Danielsen C
Abstract:
Aim and Objectives
This audit evaluated the effectiveness of the current domiciliary triaging system within Cwm Taf Morgannwg University Health Board (CTMUHB) by assessing whether the initial triage category remained correct after patient assessment, in accordance with local guidelines Categories for Domiciliary Visits. The aim was to reduce the discrepancy between the triaged referral and presenting complaint, to improve patient flow so those in most urgent need are prioritised.
Design
A two-cycle retrospective audit was conducted using records from new patient assessments and emergency domiciliary appointments from clinicians across Ysbyty Cwm Cynon, Dewi Sant and Bridgend. Cycle one reviewed 190 records over three months; cycle two reviewed 50 records over six weeks following an intervention of teaching at locality meetings and adjustment of history taking. Data collected included triage category at referral, referral source (online, self, telephone) and final clinical category on presentation.
Results
On initial audit, 46 patients had a discrepancy in triage category (24%) versus presentation, with 36 of these discrepancies (78%) presenting with less urgent issues than assessed. All discrepancies originated from self or telephone referrals, with telephone referrals being triaged by both administrative staff (80% of discrepancies) and clinical staff. Following intervention, cycle two showed a decrease in discrepancies (14%) with all discrepancies stemming solely from telephone referrals. Discrepancy responsibility was more balanced between clinicians (43%) and admin staff (57%).
Conclusion
The audit demonstrated errors in the triaging system leading to incorrect categorisation and time-frames for assessment, with main issues in the telephone referral process. Revision of the referral system, continued training and structured triage protocols are recommended.
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