The document discusses the referral system in healthcare. It defines referral as sending a patient to another physician for management of a specific problem, while the original physician coordinates total care. Factors affecting referrals include specialist availability, physician specialty, training, and uncertainty in diagnosis. The referral process involves decision making, considering the patient's background, selecting an appropriate specialist, preparing the patient and family, and preparing the consultant. Benefits are prompt diagnosis and management for patients, learning for physicians, and improved quality of care. Types of referrals include mandatory, elective, interval, collateral, cross-referral, and self-referral. The purposes are to provide comprehensive care and access to specialized services. The roles of nurses include observing

2. Mr. RushikeshHange
S.Y.Basic Bsc Nursing
MVP’SINE ADGAON NASHIK
Refferal System

3. ◼️Introduction
Referral system is an essential component of
health care system. From rural level to
metropolises and from health sub-centres to
specialist hospitals,all kinds of health facilities
can be provided to the community through this
system.

4. ◼️Definition of Refferal System
Referral System, involves sending a
patient to another physician for ongoing
management of specific problem , with
the exception that the patient will
continue to see the original physician for
coordination of total care.

5. ◼️Factors Affecting Refferal System
A. Availability of qualified consultants.
B. Physician specialty.
C. Length of training.
D. Unexplained findings
E. Uncertainty of diagnosis

6. ◼️Refferal Process
✔️ The decision is made.
✔️ Consideration is given to the patient’s medical,
emotional and socioeconomic background.
✔️Selection of appropriate specialty and appropriate
physician in the field.
✔️ Preparation for both the patient and the family for
consultation.
✔️ Preparation of the consultant.

8. ◼️Benefits of Refferal System
✔️For the patient
- Prompt diagnosis and management
- Save time, money and effort.
- Better outcome
✔️For the family physician
- learning and training
- Gaining self confidence.
-Increase communication between the health care staff
✔️For the Consultant
- Improve the quality of the patient’s management.
- Increase communication between the health care staff

9. ◼️Types of Refferal System
1. According
to the Case
2. Modern
Classification

10. 1.According to the Case
⚪Mandatory
⚪Elective
▪️ In which the patient is likely to suffer if
not refferd
▪️Where the patient is unlikely to suffer
harm if not referred.

11. 2.Modern Classification
Interval Collateral
Cross-
refferal
Split-refferal
Patient with MI admitted in hospital
for a period of then return for
continuity of time
Multi-specialty in the
same center.
As in diabetic patient with
glaucoma referral to
ophthalmologist
Self-Referral

12. ◼️Purposes of Refferal System
✔️To provide need based comprehensive care within the technical
competencies & resources at each level of primary health care
infrastructure efficiently and effectively.
✔️ To help people avail specialized services available at higher level
institution which are beyond their reach.
✔️To streamline the appropriate use of PHC infrastructure and
specialized services in order to prevent overloading of specialized
institution by direct uses.

13. ◼️Refferal Form Format
A referral form has the following information.
1. Patient details (name, location, age and sex)
2. Detail of referral doctor or hospital,
3. Reasons for referral.
4. Degree of urgency for appointment.
5. Clinical problem.
6. Important previous history.
7. Findings and Physical examination.
8. Findings on investigation.
9. Detail of given mediation, treatment and any drug sensitivities.
10. Expected outcome and desirable follow up.
Health institutions maintains the ‘Register of Referrals OUT’ and ‘Register of Referrals IN’ of all clients.

14. ◼️Refferal Form

15. ◼️Role of Nurse in Refferal System
◼️Observe and collect information about the illness, trauma, related
situation, factors etc.
◼️Identifies the nature of illness/emergency and its seriousness.
◼️ Provides immediate treatment care within her competence, standing
orders and resources available.
◼️Nurse should check the condition of the patient whether he is fit to be
shifted immediately or some emergency treatment is required.