REFERRAL Flashcards
Involves sending a patient to another physician for ongoing management of specific problem, with the exception that the patient will continue to see the original physician for coordination of total care
Referral System
A process in which the P.H.C physician who has lesser facilities to manage clinical condition seeks the assistance of specialist partner with resources to guide in managing clinical episode.
REFERRAL SYSTEM
can be done through an organizational structure for coordinating, linking and transferring responsibility of care
Referral
It does not mean transferring responsibility. But it’s sharing responsibility in patient care
Referral
It cannot take place without looking at the context in which health services delivered at its all levels
Referral system flow
Ultimately affects how various aspect of health system function where to direct your patient first in seeking a healthcare medical service in order to have adequate care management.
Referral system flow
When to refer?
• When the family physician needs specified investigation or advice.
• When the family physician is dissatisfied with the patients’ progress or unsure of the diagnosis
• When the patient or his family shows doubt or lack confidence in the diagnosis or management
• Medical-legal concerns by the physician, the patient or both
Factors affecting rerrals
a. Availability of qualified consultants
b. Physician specialty
c. Length of training
d. Unexplained findings
e. Uncertainty of diagnosis
f. Patient characteristics
g. Reimbursement plan
Factors affecting rerrals
a. Availability of qualified consultants
b. Physician specialty
c. Length of training
d. Unexplained findings
e. Uncertainty of diagnosis
f. Patient characteristics
g. Reimbursement plan
REFERRAL PROCESS
- The decision is made
- Consideration is given to the patient’s medical, emotional, cultural and socioeconomic background
- Selection of appropriate specialty and appropriate physician in the field
- Preparation for both the patient and the family for consultation
- Preparation of the consultant
- The consultant provides feedback to the family physician
- The family physician evaluates the appropriateness of the consultant’s recommendation
- The family physician facilitates the patient and the family’s acceptance of recommendation
- The family physician acts on the recommendations or selects another consultant in the same or different field
- The family physician acts on the recommendations or selects another consultant in the same or different field The family physician provides feedback to the consultant regarding the outcome
It is the process in which the treating physician at the praimary level has inadequate scales by virtue of his qualification.
Referral Process
What process do you seek assistance for a better equipped and specifically trained person with better resources at a higher level in the hospital
Referral Process
Referral Process
- Establish a good relationship with the patient
- Establish the need for a referral
- Set objectives for the referral
- Explore resources availability
- Patient decides to use or not use
- Make pre-referral treatment
- Facilitate, coordinate referral
- Evaluate and follow up
This is a benefit of referral for whom?
• Prompt diagnosis and management
• Save time, money and effort
• Better outcome
Patient
This is a Benefit of Referral for whom?
• learning and training
• gaining self confidence
• increase communication between the health care staff
Family Physician
This is a Benefit of Referral for whom?
• Improve the quality of the patient’s management
• Increase communication between the healthcare staff
Consultant
REFERRAL LETTER OUTLINE
- Patient details (name, location, age, and sex)
- Details of family physician (name of physician making request and name physician being consulted)
- Reasons for referral
- Degree of urgency for appointment
- Clinical problem
- Important previous history
- Findings on physical examination
- Findings on investigation (photocopies of results should be included)
- Medication and drug sensitivities
- Expected outcome and desirable follow up
TYPES OF REFERRAL
→ According to the Case
→ Modern Classification
• Seeking expert opinion for diagnosis and prognosis
• Seeking Hospital admission and management for the case
• Seeking further investigations
ROUTINE
To reach the expert on time before occurrence of deterioration with providing all expected information in referral letter
Emergency
• For expert opinion
• Investigations
• Admission
• Management
Opportunistic
In which the patient is likely to suffer harm if not referred
MANDATORY
Where the patient is unlikely to suffer harm if not referred
Elective
4 Modern classification of referrals.
Interval
Collateral
Split-Referral
Cross- Referral
A modern classification of referral:
Patient with MI admitted in hospital for a period of then return for continuity of time
Interval
A modern classification of referral:
As in diabetic patient with glaucoma referral to ophthalmologist
Collateral
A modern classification of referral:
Multi-specialty in the same center
Split Referral
A modern classification of referral:
Self referral
Cross-Referral
Level of referral:
From family physician primary healthcare to hospital specialist
1st
Level of referral: From specialist to another specialist
2nd
Level of referral: From junior specialist to senior
specialist
3rd
Level of referral: From general hospital to specialized
hospital
4th
DISADVANTAGES OF SELF-REFERRAL AND DIRECT ACCESS TO HOSPITAL
• Insufficient Care
• Increase Waiting Time
• Lack of Continuity and follow-up
• Loosing way between hospital different sectors
• Wastage of resources at all levels
3 BASIC PRINCIPLES OF REFERRAL
- MERIT IN THE REFERRAL PROCESS
- PRACTICAL
- INDIVIDUALIZED TO CLIENT
REASONS FOR REFERRAL
• To seek expert opinion
• To seek additional or different services
• To seek admission and management
• To seek use of diagnostic & therapeutic tools
• For co-management or further management of the illness
• For continuity of care
Is just a beginning of a process which would continue by following the patient in the hospital by visits or telephone discussion and on discharge he must be followed through home visits
Referral System
What do you call it when the hospitals should establish an office for collecting and sending feed back to the referring physician
A two way referral
process is a systematic problem-solving approach that helps clients to use resources that meet their health care neods.
REFERRAL
Home care referrals are often made before discharge for the following clients
OLDER ADULTS
CHILDREN WITH COMPLEX CONDITIONS
FRAIL PERSONS WHO LIVE ALONE
