REFERRAL

Question 1

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

Answer 1

Referral System

Question 2

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.

Answer 2

REFERRAL SYSTEM

Question 3

can be done through an organizational structure for coordinating, linking and transferring responsibility of care

Answer 3

Referral

Question 4

It does not mean transferring responsibility. But it’s sharing responsibility in patient care

Answer 4

Referral

Question 5

It cannot take place without looking at the context in which health services delivered at its all levels

Answer 5

Referral system flow

Question 6

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.

Answer 6

Referral system flow

Question 7

When to refer?

Answer 7

• 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

Question 8

Factors affecting rerrals

Answer 8

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

Question 9

Factors affecting rerrals

Answer 9

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

Question 10

REFERRAL PROCESS

Answer 10

1. The decision is made
2. Consideration is given to the patient’s medical, emotional, cultural and socioeconomic background
3. Selection of appropriate specialty and appropriate physician in the field
4. Preparation for both the patient and the family for consultation
5. Preparation of the consultant
6. The consultant provides feedback to the family physician
7. The family physician evaluates the appropriateness of the consultant’s recommendation
8. The family physician facilitates the patient and the family’s acceptance of recommendation
9. The family physician acts on the recommendations or selects another consultant in the same or different field
10. 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

Question 11

It is the process in which the treating physician at the praimary level has inadequate scales by virtue of his qualification.

Answer 11

Referral Process

Question 12

What process do you seek assistance for a better equipped and specifically trained person with better resources at a higher level in the hospital

Answer 12

Referral Process

Question 13

Referral Process

Answer 13

1. Establish a good relationship with the patient
2. Establish the need for a referral
3. Set objectives for the referral
4. Explore resources availability
5. Patient decides to use or not use
6. Make pre-referral treatment
7. Facilitate, coordinate referral
8. Evaluate and follow up

Question 14

This is a benefit of referral for whom?

• Prompt diagnosis and management
• Save time, money and effort
• Better outcome

Answer 14

Patient

Question 15

This is a Benefit of Referral for whom?

• learning and training
• gaining self confidence
• increase communication between the health care staff

Answer 15

Family Physician

Question 16

This is a Benefit of Referral for whom?

• Improve the quality of the patient’s management
• Increase communication between the healthcare staff

Answer 16

Consultant

Question 17

REFERRAL LETTER OUTLINE

Answer 17

1. Patient details (name, location, age, and sex)
2. Details of family physician (name of physician making request and name physician being consulted)
3. Reasons for referral
4. Degree of urgency for appointment
5. Clinical problem
6. Important previous history
7. Findings on physical examination
8. Findings on investigation (photocopies of results should be included)
9. Medication and drug sensitivities
10. Expected outcome and desirable follow up

Question 18

TYPES OF REFERRAL

Answer 18

→ According to the Case
→ Modern Classification

Question 19

• Seeking expert opinion for diagnosis and prognosis
• Seeking Hospital admission and management for the case
• Seeking further investigations

Answer 19

ROUTINE

Question 20

To reach the expert on time before occurrence of deterioration with providing all expected information in referral letter

Answer 20

Emergency

Question 21

• For expert opinion
• Investigations
• Admission
• Management

Answer 21

Opportunistic

Question 22

In which the patient is likely to suffer harm if not referred

Answer 22

MANDATORY

Question 23

Where the patient is unlikely to suffer harm if not referred

Answer 23

Elective

Question 24

4 Modern classification of referrals.

Answer 24

Interval
Collateral
Split-Referral
Cross- Referral

Question 25

A modern classification of referral: Patient with MI admitted in hospital for a period of then return for continuity of time

Answer 25

Interval

Question 26

A modern classification of referral: As in diabetic patient with glaucoma referral to ophthalmologist

Answer 26

Collateral

Question 27

A modern classification of referral: Multi-specialty in the same center

Answer 27

Split Referral

Question 28

A modern classification of referral: Self referral

Answer 28

Cross-Referral

Question 29

Level of referral: From family physician primary healthcare to hospital specialist

Answer 29

1st

Question 30

Level of referral: From specialist to another specialist

Answer 30

2nd

Question 31

Level of referral: From junior specialist to senior specialist

Answer 31

3rd

Question 32

Level of referral: From general hospital to specialized hospital

Answer 32

4th

Question 33

DISADVANTAGES OF SELF-REFERRAL AND DIRECT ACCESS TO HOSPITAL

Answer 33

• Insufficient Care • Increase Waiting Time • Lack of Continuity and follow-up • Loosing way between hospital different sectors • Wastage of resources at all levels

Question 34

3 BASIC PRINCIPLES OF REFERRAL

Answer 34

- MERIT IN THE REFERRAL PROCESS - PRACTICAL - INDIVIDUALIZED TO CLIENT

Question 35

REASONS FOR REFERRAL

Answer 35

• 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

Question 36

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

Answer 36

Referral System

Question 37

What do you call it when the hospitals should establish an office for collecting and sending feed back to the referring physician

Answer 37

A two way referral

Question 38

process is a systematic problem-solving approach that helps clients to use resources that meet their health care neods.

Answer 38

REFERRAL

Question 39

Home care referrals are often made before discharge for the following clients

Answer 39

OLDER ADULTS CHILDREN WITH COMPLEX CONDITIONS FRAIL PERSONS WHO LIVE ALONE