Procedure and Process for Patient Referrals
The process of patient referral in Vitas Innovative Hospice Care can be made by any healthcare professional that identifies the apparent need for the procedure. Importantly, the patient’s general practitioner must be notified of the fact of the referral. The patient who is being referred should be aware and display a sufficient understanding of the fact of the referral and must give informed consent for the procedure (Hoffmann & Del Mar 2015). In addition to the consent, the patient would be expected to satisfy several criteria, such as age, the existence of a progressive illness or an adverse health condition demanding supportive care, and the presence of needs displayed either by the patient or his/her family that is not determined by the diagnosis. Once referred, the patient will be listed in the queue and contacted within a certain period determined by the urgency of the matter.
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The received referrals are discussed during a scheduled referral meeting every day at a specified time. If the referral indicates the need for urgency, is received after the daily meeting, and the timing does not allow to postpone the decision for the next day, the request is reviewed by a senior clinician. If the referral is made for daycare or outpatient services, it is instead handled by the community nursing service within two days. Once the most appropriate are is determined, the patient is referred to the respective service. The most urgent cases will be processed within a single day whereas those requiring non-urgent advice will take up to ten days depending on the workload within the department and the individual needs of the patient. The approximate date of contact will be specified in the referral form. The patients will be subject to a needs assessment unless the written information is available from the healthcare professionals who conducted a referral (common in the case of referrals to inpatient care).
Experience in the Clinical Setting
The patient whom I had to refer to was an individual who experienced breathlessness and stress associated with the progression of lung cancer. Since the issue required community nursing service referral, I began with the assessment of the benefits of referring to the patient. Once the benefits were apparent, I contacted the patient’s general practitioner and discussed her current condition, the treatment she was receiving, laid out the proposed intervention, outlined the expected benefits, and discussed the possible adverse effects I may have overlooked. Specifically, I was expecting to achieve the improvement of the patient’s physical condition as well as a possible enhancement of her emotional state as a result of the referral (Michaels, 2016).
After the confirmation from the clinician was received, I tried to determine whether the patient’s goals were consistent with the outcomes provided by the referral. Specifically, I suggested to the patient a breathing course and explained in detail that it might provide relief for breathing but would not have major effects on the progression of the condition. Once I was able to confirm sufficient understanding on the part of the patient, I obtained from her an informed consent and made a referral to the community nursing service that runs a breathing program. I also made sure to contact the patient’s relatives to clarify the details and expected outcomes of the program and rule out the possible misconceptions regarding the practice. As a result of the participation in the program, the patient was able to decrease the severity of breathlessness, increase physical endurance, and alleviate emotional issues.
Hoffmann, T. C., & Del Mar, C. (2015). Patients’ expectations of the benefits and harms of treatments, screening, and tests: A systematic review. JAMA Internal Medicine, 175(2), 274-286.
Michaels, C. (2016). The importance of exercise in lung cancer treatment. Translational Lung Cancer Research, 5(3), 235-238.