What is a Referral?

Introduction

A referral in CAREFUL is a formal request from one team to another to take responsibility for a patient's care. Referrals are used for shared care arrangements, specialist consultations, or permanent transfers of responsibility between clinical teams.

Before You Start

• You must be a member of the team currently responsible for the patient
• You need the patient to be under your team's care
• The "Refer Patient to Team" option appears in the patient profile menu only when you have team membership in common with the patient

What Happens After a Referral?

Once a referral is sent, three outcomes are possible:

1. The Receiving Team Accepts

When the receiving team clicks the Accept button in their Referrals tab, the patient is immediately added to their patient list. Both teams now share responsibility for the patient's care. The referral disappears from both the "Referrals received" and "Referrals sent" tables.

2. The Receiving Team Rejects

If the receiving team clicks the Reject button, the referral is declined and removed from both teams' referral lists. The patient remains solely under the care of the sending team.

3. The Sending Team Cancels

Before the referral is accepted or rejected, the sending team can click the Cancel button in their "Referrals sent" table to withdraw the request. The referral is immediately removed from both teams' referral lists.

How to Send a Referral

Simple Referral

1. Navigate to the patient's profile page
2. Click the context menu button (three vertical dots) in the header
3. Select Refer Patient to Team from the menu
4. The "Submit referral request for [PATIENT NAME]" dialog opens
5. Begin typing a team name in the search field (placeholder text: "Start typing a teams name to search...")
6. Select the target team from the autocomplete results
   • Note: Some teams may show with a reason in brackets (e.g., "Cardiology (Patient already member)") indicating they cannot receive the referral
7. Click Submit referral request
8. The referral is sent and appears in:
   • Your team's "Referrals sent" table
   • The receiving team's "Referrals received" table

Referral with Notes and Attachments

For more complex referrals requiring clinical context:

1. Follow steps 1-3 above to open the referral dialog
2. Select the source team from the From dropdown (if the patient belongs to multiple teams)
3. Select the target team from the To dropdown
4. Enter clinical details in the Reason for Referral textarea
   • The placeholder suggests using SBAR format (Situation, Background, Assessment, Recommendation)
5. Optionally attach files by clicking the file upload button under Attachments
   • Attached files can be viewed by the receiving team before they accept
6. Click Refer

Immediate Transfer (Automatic Accept)

If you are a member of both the sending and receiving teams, you can complete the referral and discharge in one step:

1. Follow the referral process with notes and attachments (above)
2. Check the box labeled Transfer Immediately? (This will ACCEPT the referral request and DISCHARGE from sending team)
3. Click Refer
4. The patient is immediately:
   • Added to the target team
   • Discharged from the source team

Important: This option only appears when you're a member of both teams and there are no orphaned actions that would be left behind.

Viewing Your Team's Referrals

Received Referrals

1. Navigate to your team view from the sidebar (click Teams, then select your team name)
2. Click the Referrals tab
3. The "Referrals received" section shows all pending referrals your team has received
4. Each row displays:
   • Patient name (clickable link to patient profile)
   • Source team name (clickable link to that team)
   • Note with clinical details (if provided)
   • Attachments count badge and view button (if attachments were included)
   • Accept button (green with checkmark)
   • Reject button (red with cross)
5. Click view to open an image carousel if attachments are present
6. Click Accept or Reject to respond to the referral
   • Both buttons are disabled while processing to prevent duplicate actions
   • On success, the referral is removed from the table
   • If an error occurs, a "Referral Error" dialog appears with details

Sent Referrals

1. In the same Referrals tab, scroll down to the "Referrals sent" section
2. This shows all referrals your team has sent that are awaiting response
3. Each row displays:
   • Patient name (clickable link)
   • Target team name (clickable link)
   • Cancel button (red with cross)
4. Click Cancel to withdraw a referral before it's accepted

If a team has no pending referrals, you'll see the message:

• "This team has no outstanding received referrals"
• "This team has no outstanding sent referrals"

Understanding Referrals vs. Transfers

Referral

A referral is a request for another team to share responsibility for a patient. After acceptance, both teams can see and manage the patient. Referrals do NOT automatically transfer actions (tasks) to the receiving team.

Transfer

A transfer is a complete handoff of care from one team to another. It requires:

1. A referral (requesting the new team to take responsibility)
2. The new team accepting the referral
3. Discharging the patient from the original team

For complete transfers, it's good clinical practice to also perform a handover to ensure actions are reassigned to the receiving team before discharge.

Automatic Transfer

Using the "Transfer Immediately?" checkbox combines all three steps into one action, but is only available when you're a member of both teams.

Tips

• Use SBAR format in the "Reason for Referral" field for clinical consistency (Situation, Background, Assessment, Recommendation)
• Attach relevant documents such as imaging results, consultation notes, or test reports to give the receiving team full context
• Check the referrals tab regularly to respond to incoming referrals promptly
• Review attachments before accepting a referral by clicking the view button
• Cancel unwanted sent referrals quickly to keep your referrals list clean
• Use immediate transfer for routine ward-to-ward moves within your organization when both teams share members

Common Issues

"Refer Patient to Team" option not visible

• This means you don't have team membership in common with the patient. Only members of the patient's current team(s) can initiate referrals.

Team shows with "Invalid Reason" in search results

• The system prevents referrals to teams where the patient is already a member, or where other business rules apply. The reason is shown in brackets next to the team name.

"Transfer Immediately?" checkbox is grayed out

• You must be a member of both the sending and receiving teams to use automatic transfer
• Outstanding actions assigned to sending team members must be resolved first

Referral Error dialog appears

• Read the error message carefully
• Common issues: permission problems, patient status conflicts, or validation failures
• Click close and try again, or contact your administrator

Related Features

• Handovers: Transfer individual patient responsibility between clinicians within the same team
• Discharge Patient: Remove a patient from your team's care when their episode is complete
• Patient Actions: Review and reassign tasks before transferring patients between teams