Referral and Consultation
Referral and Consultation are prescribing processes in which one provider (prescriber) requests services of another provider (consultant). For clarity, we refer to Consults as requests that are fulfilled in inpatient or emergency contexts and Referrals as requests that are fulfilled in outpatient contexts. The “Consultant” is the physician fulfilling the request and the “Referrer” is the prescriber generating the request.
Talk before Clicking
While Connect Care can facilitate documentation of consultation activities, prescribers remain responsible for contacting the desired service to make sure that any urgency is clearly understood. Routine (e.g. pre-op) consults may be communicated by medical support staff in some circumstances. The act of calling-in a consult will also clarify which prescriber is responsible for the consultation.
Quality Questions beget Quality Responses
Connect Care can help with a lot of the logistics and administrative hassles associated with consultation and referral. It remains the referrer's responsibility to clearly articulate an actionable question. While consultants have access to the patient's full chart when triaging or fulfilling requests, they cannot read the mind of the referrer to determine exactly what help is needed most. Please ensure that referrer questions and comments follow QuRE guides.
Finding Outpatient Services
The Alberta Referral Directory (ARD), linked to all outpatient referral orders, contains information about available outpatient specialty services, their consultants, requirements for referrals and instructions about how to facilitate efficient referral access. The ARD is important, but possibly incomplete.
Finding Inpatient Consultants
A facility locating service, or regional on-call application (ROCA linked to a Connect Care dashboard), can help identify who is accepting urgent consults at a particular facility, for a particular specialty, at a specific time. Connect Care consultation orders include a pick-list for the inpatient provider group to be consulted. These pick-lists match ROCA content.
It can also help to be aware of the clinical department structure within Connect Care, as this is reflected in lists of "internal" outpatient clinics that use the Connect Care as their record of care. A Connect Care "department" does not have the same meaning as a facility, zone or academic department. Instead, it is an organizational construct that controls clinical information system (CIS) functions available for a specific clinical service.
Personalizing Consultation and Referral Orders
Physicians may appoint colleague(s) to help produce custom lists of consultations and referrals commonly used by their division or specialty. Those so designated may find it helpful to browse a master list of all available Wave 1 "departments" (the clinics and services that one can direct to), together with the problem types that would land patients in specific clinics.