logging in or signing up referral spk123spk123 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 515 Category: Entertainment License: All Rights Reserved Like it (3) Dislike it (0) Added: September 03, 2010 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: abhikirana (6 month(s) ago) hi sir, this is very good presentation. will you please send me this to my id smitabtiro@gmailcom Saving..... Post Reply Close Saving..... Edit Comment Close By: poornypurushoth (9 month(s) ago) hello...sir .could u pls...sent this presentation on my id- poornypurushoth@gmail.com................... Saving..... Post Reply Close Saving..... Edit Comment Close By: hooda.anju (11 month(s) ago) sir will you please send this ppt on y id - hooda.anju@yahoo.com. i will be thankful to you Saving..... Post Reply Close Saving..... Edit Comment Close By: nnaemekaanyahara (15 month(s) ago) I love this presentation from the manuscripts Thank you pls send a copy to drannaemeka@yahoo.com Saving..... Post Reply Close By: spk123spk123 (15 month(s) ago) thank you for your commends.... Saving..... Edit Comment Close Premium member Presentation Transcript Slide 1: 9/3/2010 REFERRAL CHAIN 1 Slide 2: REFERRAL CHAIN INTRODUCTION : It would be desirable to develop a referral system of referral from one level to the other with laid down procedures and policies so that these institutions give required referral services. It should be emphasized that referral is a two way process and that the retention of patients in referral institutions should be as brief as possible. INTRODUCTION DEFINITION : Referral is a process of directing someone to another source of assistance. Referral is the act or instance of sending or directing someone for treatment, aid, information or a decision. DEFINITION REFERRAL AND THE CONTINUUM OF CARE : Referral can be an important tool in ensuring a continuum of care for clients by helping them to access all the relevant services available to address their physical, psychological and social needs. REFERRAL AND THE CONTINUUM OF CARE REFERRAL PROCESS : The referral process is a systematic problem solving approach involving series of actions that help clients use resources for the purpose of resolving needs. Clients may be individuals or groups who require assistance from others in order to achieve their maximum level of functioning. REFERRAL PROCESS 9/3/2010 REFERRAL CHAIN 6 PRINCIPLES : The referral should meet the needs and objectives of the clients and should be necessary and appropriate – there should be merit in referral. The client should be able to use the referral in an efficient, effective manner – it should be practical. The referral should be individualized to the client. The referral should be timely. The referral should be coordinated with other activities. The referral should incorporate the client and family into planning and implementation. The referred should have the right to refuse the referral. PRINCIPLES The nurse should be aware of : : Address and telephone number of the client. Client’s age, sex and marital status. Name, and birth dates of family member and significant. Source of medical care and health history. Financial status and records. Reasons for seeking reforms. The nurse should be aware of : 9/3/2010 REFERRAL CHAIN 8 The basic steps of the referral process : Establish a working relationship with the client. Define the need for a referral. Set objectives for the referral. Explore resource availability. Client decides to use or not use referral. Make referral to a resource. Facilities and follow up. The basic steps of the referral process 9/3/2010 REFERRAL CHAIN 9 BARRIERS TO REFERRAL PROCESS : Resource barriers Attitude of health care professionals Physical accessibility of resources Cost of resources Client barriers Priorities Motivation Previous experience with resources Lack of knowledge about available resources Lack of understanding regarding need for referral Client self-image (-ve) Cultural factors Finances Accessibility BARRIERS TO REFERRAL PROCESS 9/3/2010 REFERRAL CHAIN 10 ESTABLISHING CRITERIA FOR REFERRAL : The community health nurse uses outcome –based clinical evidence to establish guidelines for initiating referrals. Screening test results that fall outside of normal parameters and require follow-up evaluation indicate the need for referral. For example, any participant with a blood pressure reading 140/100 mm Hg or above should be referred for follow up. ESTABLISHING CRITERIA FOR REFERRAL REFERRAL HOSPITALS IN HEALTH CARE : Referral hospitals include secondary and tertiary-level hospitals designed to provide specialized care to patients referred from lower levels of the health system. The care offered in referral hospitals is more expensive than that provided in primary health centers—the care is more complex and specialists are usually higher paid Beyond treating patients, referral hospitals train doctors, conduct research, set standards for quality of care, and provide guidance and support to other levels of the health system. REFERRAL HOSPITALS IN HEALTH CARE Specialist services in secondary (regional) hospitals typically include: : • Internal medicine; • General surgery, including emergency care; • Obstetrics and gynaecology; • Paediatrics; and • Other specialties, such as mental health care, depending on the pattern of medical practice in the country. Specialist services in secondary (regional) hospitals typically include: 9/3/2010 REFERRAL CHAIN 13 Tertiary hospital services may include these services plus: : • Full intensive care unit; • Specialized burns intensive care unit; • Specialized diagnostics, such as CT scans and MRIs (advanced medical imaging technologies); • Specialized surgery, such as neurosurgery; and • Other medical specialties such as gastroenterology or oncology. Tertiary hospital services may include these services plus: 9/3/2010 REFERRAL CHAIN 14 The Role of Referral Hospitals : • Offering Advice and Support to Lower-Level Health Facilities. • Providing Quality Assurance and Improvement. • Education and Training. • Management and Administration. • Research and Innovation. The Role of Referral Hospitals 9/3/2010 REFERRAL CHAIN 15 How Distortions Arise in the Health System : • Some urban residents use referral hospitals for regular health care visits because they prefer them. This can lead to inequitable use of hospitals by better-off people. How Distortions Arise in the Health System Slide 17: • Outpatient departments in particular can become congested with patients seeking primary health care, resulting in long waiting lines of patients who could be successfully treated at other facilities. • In countries hard hit by the AIDS epidemic, AIDS patients are occupying beds in referral hospitals for long periods when they would be better cared for in lower-level facilities. 9/3/2010 REFERRAL CHAIN 17 Slide 18: • Some referral hospitals may introduce inappropriate or unaffordable technologies. • Skilled health personnel may find it more attractive and rewarding to work in referral hospitals, depriving rural and district health facilities of the professional expertise they desperately need—also a health equity issue. Slide 19: Finding the Appropriate Balance of Care Getting Better Value for Money From the Hospital System Redesigning Referral Hospital Management • Reducing inappropriate use of outpatient services and unnecessary referrals for inpatient services • Allowing early discharge from the hospital • Ensuring that referral hospitals conform as much as possible with available evidence on economies of scale—that is, no fewer than 200 beds and no more than 600 beds. 9/3/2010 REFERRAL CHAIN 19 Innovative Public-Private Partnerships : • Allowing competition among public and private hospitals to encourage higher quality and lower costs; • Establishing private wards in public hospitals to generate additional income; and • Contracting out services to private providers, particularly high-cost, low-volume services, to offer these services more efficiently to public patients. Innovative Public-Private Partnerships 9/3/2010 REFERRAL CHAIN 20 Enhancing Referral System Functions : • Improving design by assessing which services should be provided at what level of care, including home and community-based care; primary health care; and district, secondary, tertiary, and other specialized hospitals; • Transferring information better between levels of care and from a geographic perspective, ensuring patients have transportation arrangements from remote areas when needed; and • Instilling “referral discipline” by fast-tracking patients who are referred and explaining to non-referred patients that they need to wait or go to another facility for care. Enhancing Referral System Functions 9/3/2010 REFERRAL CHAIN 21 BEST PRACTICES : CHN respects the client’s right to refuse a referral CHN develops referrals that are timely, merited, practical, tailored to the client, client oriented and coordinated Client is an active participant in the process and the CHN involves family members as appropriate CHN establishes a relationship based on trust, respect, caring and listening. CHN allows for client dependency in the client – CHN relationship until the client’s self-care capacity sufficiently develops. CHN develops comprehensive, seamless, client-sensitive resources that routinely monitor their own systems for barriers. BEST PRACTICES Slide 23: EVALUATING THE EFFECTIVENESS OF A REFERRAL Name of the agency………………………………………………………………. 9/3/2010 REFERRAL CHAIN 23 Slide 24: 9/3/2010 REFERRAL CHAIN 24 CONCLUSIONS : Referral hospitals often command a large share of health sector budgets and spending, yet no simple formula exists for assessing what an appropriate share would be. Strong referral hospitals can distort priorities and undermine basic services, but they also provide important health benefits to the patients they treat successfully. Also, the lower levels of the health care system cannot function effectively without access to referrals for more specialized care. “Referral hospitals should perhaps be seen as the capstone of the health care pyramid: they should not be too heavy, but if they are too light, the levels below them will lose cohesion,” CONCLUSIONS 9/3/2010 REFERRAL CHAIN 25 REFERENCE : BT Basavanthappa. Community Health Nursing. 2nd edition. Bengaluru (India): Jaypee publications; 2008 Gulani K.K. Community Health Nursing- Principles and Practices.1st edition. Kumar Publishing House;Delhi: 2006. Baride. J. P. and Kulkarni. A. P. Text book of community medicine. 3rd edition. Mumbai: Vora medical publications;2006 S. Keshav. Community health nursing. 2nd edition. N.R. Brothers; Indore: 2007 Hunt Roberta. Introduction to community based nursing. 4th edition. Lippincott Williams & Wilkins. Philaldelphia; 2009 M.A Frances and M.S. Smith. Community/ Public Health Nursing Practice. 3rd edition. Elsevier Saunders: US; 2000 Disease control priority project. Referral hospitals. Retrieved on 16 August, 2010 from http://www.dcp2.org/file/155/dcpp-referralhospitals.pdf REFERENCE 9/3/2010 REFERRAL CHAIN 26 Slide 27: 9/3/2010 REFERRAL CHAIN 27 You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.
referral spk123spk123 Download Post to : URL : Related Presentations : Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Uploaded from authorPOINT lite Insert YouTube videos in PowerPont slides with aS Desktop Copy embed code: (To copy code, click on the text box) Embed: URL: Thumbnail: WordPress Embed Customize Embed The presentation is successfully added In Your Favorites. Views: 515 Category: Entertainment License: All Rights Reserved Like it (3) Dislike it (0) Added: September 03, 2010 This Presentation is Public Favorites: 0 Presentation Description No description available. Comments Posting comment... By: abhikirana (6 month(s) ago) hi sir, this is very good presentation. will you please send me this to my id smitabtiro@gmailcom Saving..... Post Reply Close Saving..... Edit Comment Close By: poornypurushoth (9 month(s) ago) hello...sir .could u pls...sent this presentation on my id- poornypurushoth@gmail.com................... Saving..... Post Reply Close Saving..... Edit Comment Close By: hooda.anju (11 month(s) ago) sir will you please send this ppt on y id - hooda.anju@yahoo.com. i will be thankful to you Saving..... Post Reply Close Saving..... Edit Comment Close By: nnaemekaanyahara (15 month(s) ago) I love this presentation from the manuscripts Thank you pls send a copy to drannaemeka@yahoo.com Saving..... Post Reply Close By: spk123spk123 (15 month(s) ago) thank you for your commends.... Saving..... Edit Comment Close Premium member Presentation Transcript Slide 1: 9/3/2010 REFERRAL CHAIN 1 Slide 2: REFERRAL CHAIN INTRODUCTION : It would be desirable to develop a referral system of referral from one level to the other with laid down procedures and policies so that these institutions give required referral services. It should be emphasized that referral is a two way process and that the retention of patients in referral institutions should be as brief as possible. INTRODUCTION DEFINITION : Referral is a process of directing someone to another source of assistance. Referral is the act or instance of sending or directing someone for treatment, aid, information or a decision. DEFINITION REFERRAL AND THE CONTINUUM OF CARE : Referral can be an important tool in ensuring a continuum of care for clients by helping them to access all the relevant services available to address their physical, psychological and social needs. REFERRAL AND THE CONTINUUM OF CARE REFERRAL PROCESS : The referral process is a systematic problem solving approach involving series of actions that help clients use resources for the purpose of resolving needs. Clients may be individuals or groups who require assistance from others in order to achieve their maximum level of functioning. REFERRAL PROCESS 9/3/2010 REFERRAL CHAIN 6 PRINCIPLES : The referral should meet the needs and objectives of the clients and should be necessary and appropriate – there should be merit in referral. The client should be able to use the referral in an efficient, effective manner – it should be practical. The referral should be individualized to the client. The referral should be timely. The referral should be coordinated with other activities. The referral should incorporate the client and family into planning and implementation. The referred should have the right to refuse the referral. PRINCIPLES The nurse should be aware of : : Address and telephone number of the client. Client’s age, sex and marital status. Name, and birth dates of family member and significant. Source of medical care and health history. Financial status and records. Reasons for seeking reforms. The nurse should be aware of : 9/3/2010 REFERRAL CHAIN 8 The basic steps of the referral process : Establish a working relationship with the client. Define the need for a referral. Set objectives for the referral. Explore resource availability. Client decides to use or not use referral. Make referral to a resource. Facilities and follow up. The basic steps of the referral process 9/3/2010 REFERRAL CHAIN 9 BARRIERS TO REFERRAL PROCESS : Resource barriers Attitude of health care professionals Physical accessibility of resources Cost of resources Client barriers Priorities Motivation Previous experience with resources Lack of knowledge about available resources Lack of understanding regarding need for referral Client self-image (-ve) Cultural factors Finances Accessibility BARRIERS TO REFERRAL PROCESS 9/3/2010 REFERRAL CHAIN 10 ESTABLISHING CRITERIA FOR REFERRAL : The community health nurse uses outcome –based clinical evidence to establish guidelines for initiating referrals. Screening test results that fall outside of normal parameters and require follow-up evaluation indicate the need for referral. For example, any participant with a blood pressure reading 140/100 mm Hg or above should be referred for follow up. ESTABLISHING CRITERIA FOR REFERRAL REFERRAL HOSPITALS IN HEALTH CARE : Referral hospitals include secondary and tertiary-level hospitals designed to provide specialized care to patients referred from lower levels of the health system. The care offered in referral hospitals is more expensive than that provided in primary health centers—the care is more complex and specialists are usually higher paid Beyond treating patients, referral hospitals train doctors, conduct research, set standards for quality of care, and provide guidance and support to other levels of the health system. REFERRAL HOSPITALS IN HEALTH CARE Specialist services in secondary (regional) hospitals typically include: : • Internal medicine; • General surgery, including emergency care; • Obstetrics and gynaecology; • Paediatrics; and • Other specialties, such as mental health care, depending on the pattern of medical practice in the country. Specialist services in secondary (regional) hospitals typically include: 9/3/2010 REFERRAL CHAIN 13 Tertiary hospital services may include these services plus: : • Full intensive care unit; • Specialized burns intensive care unit; • Specialized diagnostics, such as CT scans and MRIs (advanced medical imaging technologies); • Specialized surgery, such as neurosurgery; and • Other medical specialties such as gastroenterology or oncology. Tertiary hospital services may include these services plus: 9/3/2010 REFERRAL CHAIN 14 The Role of Referral Hospitals : • Offering Advice and Support to Lower-Level Health Facilities. • Providing Quality Assurance and Improvement. • Education and Training. • Management and Administration. • Research and Innovation. The Role of Referral Hospitals 9/3/2010 REFERRAL CHAIN 15 How Distortions Arise in the Health System : • Some urban residents use referral hospitals for regular health care visits because they prefer them. This can lead to inequitable use of hospitals by better-off people. How Distortions Arise in the Health System Slide 17: • Outpatient departments in particular can become congested with patients seeking primary health care, resulting in long waiting lines of patients who could be successfully treated at other facilities. • In countries hard hit by the AIDS epidemic, AIDS patients are occupying beds in referral hospitals for long periods when they would be better cared for in lower-level facilities. 9/3/2010 REFERRAL CHAIN 17 Slide 18: • Some referral hospitals may introduce inappropriate or unaffordable technologies. • Skilled health personnel may find it more attractive and rewarding to work in referral hospitals, depriving rural and district health facilities of the professional expertise they desperately need—also a health equity issue. Slide 19: Finding the Appropriate Balance of Care Getting Better Value for Money From the Hospital System Redesigning Referral Hospital Management • Reducing inappropriate use of outpatient services and unnecessary referrals for inpatient services • Allowing early discharge from the hospital • Ensuring that referral hospitals conform as much as possible with available evidence on economies of scale—that is, no fewer than 200 beds and no more than 600 beds. 9/3/2010 REFERRAL CHAIN 19 Innovative Public-Private Partnerships : • Allowing competition among public and private hospitals to encourage higher quality and lower costs; • Establishing private wards in public hospitals to generate additional income; and • Contracting out services to private providers, particularly high-cost, low-volume services, to offer these services more efficiently to public patients. Innovative Public-Private Partnerships 9/3/2010 REFERRAL CHAIN 20 Enhancing Referral System Functions : • Improving design by assessing which services should be provided at what level of care, including home and community-based care; primary health care; and district, secondary, tertiary, and other specialized hospitals; • Transferring information better between levels of care and from a geographic perspective, ensuring patients have transportation arrangements from remote areas when needed; and • Instilling “referral discipline” by fast-tracking patients who are referred and explaining to non-referred patients that they need to wait or go to another facility for care. Enhancing Referral System Functions 9/3/2010 REFERRAL CHAIN 21 BEST PRACTICES : CHN respects the client’s right to refuse a referral CHN develops referrals that are timely, merited, practical, tailored to the client, client oriented and coordinated Client is an active participant in the process and the CHN involves family members as appropriate CHN establishes a relationship based on trust, respect, caring and listening. CHN allows for client dependency in the client – CHN relationship until the client’s self-care capacity sufficiently develops. CHN develops comprehensive, seamless, client-sensitive resources that routinely monitor their own systems for barriers. BEST PRACTICES Slide 23: EVALUATING THE EFFECTIVENESS OF A REFERRAL Name of the agency………………………………………………………………. 9/3/2010 REFERRAL CHAIN 23 Slide 24: 9/3/2010 REFERRAL CHAIN 24 CONCLUSIONS : Referral hospitals often command a large share of health sector budgets and spending, yet no simple formula exists for assessing what an appropriate share would be. Strong referral hospitals can distort priorities and undermine basic services, but they also provide important health benefits to the patients they treat successfully. Also, the lower levels of the health care system cannot function effectively without access to referrals for more specialized care. “Referral hospitals should perhaps be seen as the capstone of the health care pyramid: they should not be too heavy, but if they are too light, the levels below them will lose cohesion,” CONCLUSIONS 9/3/2010 REFERRAL CHAIN 25 REFERENCE : BT Basavanthappa. Community Health Nursing. 2nd edition. Bengaluru (India): Jaypee publications; 2008 Gulani K.K. Community Health Nursing- Principles and Practices.1st edition. Kumar Publishing House;Delhi: 2006. Baride. J. P. and Kulkarni. A. P. Text book of community medicine. 3rd edition. Mumbai: Vora medical publications;2006 S. Keshav. Community health nursing. 2nd edition. N.R. Brothers; Indore: 2007 Hunt Roberta. Introduction to community based nursing. 4th edition. Lippincott Williams & Wilkins. Philaldelphia; 2009 M.A Frances and M.S. Smith. Community/ Public Health Nursing Practice. 3rd edition. Elsevier Saunders: US; 2000 Disease control priority project. Referral hospitals. Retrieved on 16 August, 2010 from http://www.dcp2.org/file/155/dcpp-referralhospitals.pdf REFERENCE 9/3/2010 REFERRAL CHAIN 26 Slide 27: 9/3/2010 REFERRAL CHAIN 27