What is a ‘Referral’?

Referral makes another team responsible for a patient

Referral is a key concept in CAREFUL.

When one team invites another team to become responsible for a patient, this is known as a “Referral”

Referrals are usually made because one team wants another team to do one of three things:

  1. To share care for a patient, so that both teams are looking after the patient
  2. To a ‘consultation’ or opinion about a particular aspect of the patient’s care
  3. To transfer responsibility from the referring team to the receiving team more permanently

Please see the section below about Transfers — number 3 in the above list.

A referral is made from the patient profile

Referrals are always made individually, on a single patient level by invoking the “Refer Patient” option from the patient profile view. This is unlike handover, which can be made with many patients at one time.

After the referral has been made, it referral is visible in the ‘Referrals tab’ of the receiving team’s Team View

The referral is also visible as a ‘Sent’ referral in the referrals tab of the sending team

A referral can be accepted, rejected or cancelled

After the reveal has been made, three things can happen:

  1. The receiving team may elect to accept the referral – in which case the patient will be added to that team’s list of responsible patients.
  2. The receiving team may also elect to reject the referral.
  3. The sending team can also cancel the referral.

Transfer is a referral followed by a discharge

In order to transfer care entirely from one team to another it is necessary to discharge the patient from the sending team after the referral has been excepted.

Unlike handover, the referral does NOT automatically assign actions to the accepting team, so before discharging the patient, it is usually convenient to also undertake a handover between one member of the sending team and a member of the referring team, ensuring that all relevant actions are transferred with that team. This is good clinical practice.

Automatic Transfers

In the Referral dialogue box, there is an option to undertake both the referral and the discharge at the same time – in other words, to make the transfer happen in one go.

Only a user who is a member of both the sending and receiving team can do this. It is also only possible if there are not outstanding actions assigned members of the sending team that wold be left ‘orphaned’ by the transfer.

Primarily this ‘automatic’ transfer is made between teams that are working closely together and have shared team members (e.g. one part of a ward to another, or from one sub-speciality to another).

For more information, please see this page on transfers.

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