Section 4: Responsibilities During Referral

Top 3 Takeaways

1. The PCT manages the patient until seen by the SCT.
2. An online referral portal facilitates communication by uploading diagnostic test results as they come in.
3. In urgent situations, expedited communication is imperative. Prioritize direct phone communication between the SCT and PCT over email in such cases.

PCT Responsibilities During Referral

“During Referral” denotes the period when the SCT assumes the role of DV regarding the specific condition for which the PCT referred the patient. The referral period continues for as long as the SCT remains the DV and may last for one or multiple visits.

Manage care until the patient can be seen

• When the SCT’s schedule precludes seeing the patient within the timeframe deemed optimal by the PCT, the PCT should initiate communication with the SCT promptly, either electronically or via telephone.
• This facilitates discussion regarding the patient’s condition and aids in determining the most appropriate interim management strategies until the SCT can see the patient.

Keep lines of communication open

• Once referral care gets underway, clients often feel concerned about what may or may not be happening with the SCT and contact the PCT for clarification.
• The PCT should communicate these questions or concerns to the SCT. This gives the SCT the opportunity to address client issues in a timely manner that is aligned with patient care goals.

SCT Responsibilities During Referral

Upon initiating each referral relationship, the SCT should ascertain the preferred mode of communication, i.e., whether to use the referring doctor’s direct email, the hospital’s general email, or both. When in doubt or unclear, it is always appropriate to use the hospital’s general email address.

Benefits of a Web-Based Portal

These guidelines strongly encourage SCTs to use or develop a dedicated web-based portal to improve referral case communication and medical records sharing. (See Figure 4.1 for an example.)¹ Through the portal, the SCT updates the PCT on the patient’s status with anticipated or completed diagnostics and treatment, including hospitalization. The SCT can also notify the PCT of patient discharge and plans for follow-up care.

Sometimes, situations arise that require immediate notification beyond the capability of a web-based portal, such as the death or euthanasia of a patient. In these cases, the PCT or SCT should be informed immediately via telephone or electronic means (email, messaging, etc.). Failure to inform either the PCT or SCT of such events promptly could result in a team member contacting a client, only to discover the patient has died or been euthanized at the SCT or PCT facility without the other hospital’s knowledge. This type of miscommunication can harm a client’s trust in the PCT and/or SCT.

FIGURE 4.1: Example of an online referral portal

Download PDF of Figure 4.1

Referral roadmap

An easily accessible and routinely updated document, the referral roadmap provides information on how the specialty practice expects the referral process to unfold. The referral roadmap shares crucial information on the steps of the process, outlines expectations for both teams and clients, reduces uncertainty, and enhances communication. Specialty practices can distribute the roadmap to their referring practice population by mail or digitally and make it available on the specialty hospital website and/or through the referral portal. Giving clients access to the roadmap via various client-facing channels (e.g., social media, website) can improve overall communication and expectation setting. The roadmap should be periodically updated and redistributed as needed.

The referral roadmap contains the following information:

• How to initiate a referral
• Standardized referral form
• Information needed to submit a referral (e.g., medical records, diagnostic test results, time requirements)
• Instructions on submission of documents such as images and lab results
• Approximate timeline for the referral process
• Frequency and method of communication updates
• Options for the PCT to communicate with the SCT during the referral process