When you work in a health facility you can clearly appreciate the need for referrals because this is a daily activity. There are reasons of transferring cases which are beyond the technical competence of our hospital that may need to be handled by institutions of a higher level for better health services. Likewise, we also receive patients who need highly skilled manpower and equipment that are referred to us by other facilities which do not have the expertise that we enjoy.
Normally a written order is issued by the patient’s primary care doctor for you to see a specialist or get certain medical services. These referrals are important in healthcare because they promote a functional relationship between all levels of the health system, they ensure that patients receive the best possible care at the appropriate level and those in need of specialist services access them in a timely manner.
It is also important for Referral hospitals to offer significant support to personnel in lower-level facilities in terms of providing advice, communication and collaboration beyond their own hospital for better working environment.
At Our Lady of Consolata – Kisubi Hospital, we have CT-Scan services which equipment is one of the first to be installed along Entebbe Road. This has attracted many patients and referrals in from lower-level facilities in our catchment area. Apart from those patients whom we treat from within, the rest are referred in purposely for investigations and interpretation by our Radiologist thereafter a report is issued to be sent back to their doctors.
We also receive patients with request forms from the doctors who come for specific laboratory tests which results are issued to them to be taken back to their doctors for interpretation and further management.
Being a major hospital in the area, when we receive such patients we ensure that they are guided and sent back to their primary doctors however, in certain instances patients change their mind and decide to be treated from within our facility which may not be so good to the referring doctor and we try to discourage it though we also respect the patients’ rights.
If a patient is seen with very alarming results our medical workers communicate immediately with the referring health worker to allow speedy and better management, this is the reason why the contact details are clearly indicated.
However, we had a case where the patient required more specialized intervention which was available in our hospital but the referring doctor insisted on taking him back to his facility which was not able to manage and he later passed on the same day while being brought back to us. It is important that medical workers follow the right procedures and not undermine the principles. Patients should be given an opportunity to access the right medical treatment within the shortest time possible.
Like I mentioned earlier, referrals are important to patient care management and as health workers we should not compromise emergency care. Last Saturday at 1am, I received a call from one of the Medical Centers operating within our collaboration which had referred a newly born baby to our neo-natal facility. This doctor was doing his best to save the life of this little one in the wee hours but the mother did not have funds to cover the advance deposit required for this appropriate care which is a requirement. I stood in as surety for that night and indeed the next day they were able to cover their bill. However, after examining the baby there was need to refer it to the Pediatric Surgeon for further management. By nature, appropriate care in a referral hospital will tend to require more complex input and higher skill levels hence will be relatively expensive but this should not jeopardize proper patient care of our people.
After these scenarios many questions came to mind, when should health facilities refer patients, why should some retain a patient who cannot be managed in their facility hence risking people’s lives. Why not refer to the next level for better management.
Food for thought.
# Stay Safe
Patient Care Coordinator
Our Lady of Consolata – Kisubi Hospital
Date: 24th June 2020