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.
Effective referral management is key to safe and efficient patient care. All referrals and consultations must be ordered within Connect Care where it serves as the record of care. This requirement complies College of Physicians and Surgeons of Alberta (CPSA) practice standards and AHS QuRE referral guides. Using the correct Connect Care workflow ensures that consults and referrals are identified, tracked and completed in a timely manner.
Bypassing Connect Care orders by means of, for example, hallway consults, In Basket messages or chart copies, can inconvenience colleagues and risk referral loss. Clinicians who receive consult requests through informal channels should remind the requesting provider that the desired consult or referral must be entered in Connect Care. The system SmartPhrase ".REFERRALROUTING" or ".REFROUTE" can be used to pull simple instructions into a response message.
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.
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.
Referral workflow is one of the Connect Care Optimization Clinic themes, covered in all Connect Care blogging channels: