Sandringhamhospital.org.au

THE ALFRED HOSPITAL REFERRAL AND MANAGEMENT GUIDELINES
These Hospital Referral and Management Guidelines have been developed by The Alfred Hospital. The guidelines are a tool designed to assist general practitioners and hospital staff in managing Outpatient referrals. The Alfred is grateful to The Canterbury and District Health Board in New Zealand for their assistance in developing these guidelines. These guidelines have been developed by each of the Units at The Alfred with the aim of providing general practitioners and other referrers with information to assist them in deciding whether or not to refer a patient to a specialist or allied health department, and what information is required by the treating Units in the patient’s referral to assist in optimising patient care. They also contain some options to assist the referrer in the ongoing management of a patient's condition. The key principle of referral guidelines and assessment criteria is to provide waiting patients with equity of access to hospital services, and provide a transparent method of assessing their priority and eligibility within current funding constraints. Providing the necessary information required when referring patients to an Outpatient clinic allows the treating Units to accurately triage referrals and thereby provide appropriate and timely appointments. These Referral and Management Guidelines include: • Outpatient Appointment Priority Guide, which provides a guide to the likely waiting times to and Outpatient appointment in each priority category • Referral and Management guidelines for each specialty area, including clinical information and investigations which assist in triage of referrals • Primary Care Management Guidelines for some specific conditions • The Alfred Hospital Outpatient Referral Form and The Alfred Outpatient Ophthalmology All criteria and guidelines are to be considered to be merely 'guides'. As with any guidelines, generally accepted clinical practice and judgement must prevail. Please note in particular that the waiting times given for priority categories are a guide only, and times to appointment will vary depending on the demand for appointments, size and staffing of a particular clinic. If the patient’s condition changes, or if you have a concern regarding the timing of your patient’s appointment, please contact the Unit registrar via The Alfred switchboard on 9076 2000, or The Outpatient Nurse Manager on 9076 2000.
These referral guidelines are not intended to preclude a referral where the diagnosis is
unclear, or if a second opinion for management options is requested
GENERAL REFERRAL GUIDELINES
ƒ The patient's full name (and aliases) and, if appropriate, the name of the parent or care- ƒ The patient's address ƒ The patient's telephone number (home and alternative) ƒ The patient's date of birth ƒ Hospital number (UR - if known) ƒ Medicare Number ƒ Past history, including details of relevant previous treatment and investigations including x- rays, ultrasound's, endoscopy findings, blood tests, bone density, etc. (photocopied results and films where appropriate). NOTE: Details of facility where films were taken including
date. If private, patient to bring films to outpatient clinic attendance.
ƒ Presenting symptoms, their evolution and duration ƒ Physical findings ƒ Details of any previous treatment including topical and systemic medications given to the ƒ Details of any associated medical conditions which may affect the condition, or its ƒ Details of current medications and any drug allergies, eg previous adverse response to ƒ GP reason for referral, including what is the problem to be answered by specialist, urgency, degree of loss of function, pain experience. The urgency of the referral must rely on the clinical assessment of the GP and the indicated degree of concern. This information should be detailed routinely in all referrals, but often is not included. If this data is provided, valuable clinical time can be used seeing patients rather than attempting to gather information that was readily available to the referring doctor. SAMPLE MEDICAL DIRECTOR REFERRAL
Good Health Clinic
1234 Jones Street
Melbourne Vic 3004
(T) 9222-7777 (F) 9222-8888
Doctor Orthopaedic Outpatient Department DEMOGRAPHICS
(Include DOB, phone - include all contact SHORT NOTICE
(If patient is able to attend at short notice OTHER: 0404-000-000 MEDICARE: 0000-0000-0000 DIAGNOSIS OR PROBLEM/AREA OF
CAN PATIENT ATTEND AT SHORT NOTICE: YES / NO (Include advice only or diagnostic only) RE: Lesion on nose - ?BCC
Thank you for seeing John with 3cm lesion on the tip of his nose. It has been present for six months, showing a rapid increase in size over the last month. He is self-employed as a jewellery manufacturer and the lesion interferes with his line of vision during close work. IMPORTANT CLINIC INFO ESSENTIAL
(Including size of lesion, length of time present, severity, psychosocial impact, etc.) A similar lesion was removed from John's left check in 1999 by Dr Joe Bloggs
PAST MEDICAL HISTORY
Ischaemic heart disease
PREVIOUS CONTACT/SURGERY
(Include procedure, name of specialist, date REGULAR MEDICATIONS ARE:
TESTS/LABS
(Include or send copies of timely, relevant RELEVANT TEST RESULTS
Histology result from previous lesion attached. Please assess and arrange for removal of lesion. DESIRED OUTCOME

Source: http://www.sandringhamhospital.org.au/Assets/Files/GP_ReferralIntroduction.pdf