Appendix C – Management: referral

Management: Referral

The doctor refers the patient inappropriately. The referral letter is unclear and the doctor makes little attempt to keep the hospital informed of the patients change in condition.					The doctor having obtained all the necessary information refers appropriately. He/she involves the patient in this decision. A clear referral letter is written and the doctor keeps the hospital up to date with changes in the patient’s circumstances after the initial referral.
1	2	3	4	5	6	7	8	9	10
Has little understanding of this.		Attempts to do this but is not yet skilful and sometimes runs into difficulty.				Attempts to do this and is usually successful but recognises his/her limitations.			Perfect

The doctor:

Rarely

Occas
ionally

Fairly
frequently

Often

Usually

(a)

Clearly defines problems and management dilemmas.

(b)

Informs patient as to the need for referral and likely outcome.

(c)

Decides urgency of appointment .

(d)

Referral letter includes significant past medical history and regular medications.

(e)

Informs hospital of any major change in condition/ alteration in medication.

This area of behaviour can be assessed by record review and case discussion.