REFERRAL POLICY
THERAPY DEPT
INTERNAL REFERRALS:
TO OTHER SECTIONS OPD
-complete detailed clinical notes in clients blue card and yellow folder
-write a brief referral detailing exactly what you want done on the official referral form and indicate to whom you are referring
-if it requires a quick signature (to XR) or a quick injection IMI, write ‘front of queue’ on the top and send them to RU.
FROM OTHER SECTIONS OPD TO OUR OPD
-they fill in a similar referral form and indicate which therapy discipline will be seeing the client (although we can also decide that and it is generally more accurate). They detail what they want us to do.
-If this is unclear, phone the relevant person and discuss the case with them.
FROM WARDS TO US
-referrals are filled in on the official form and placed in the box/envelope marked ‘therapy’ in the duty room of the ward ON THE SAME DAY. Referrals still attached to the patients file at their bed will not necessarily be seen and therapy takes no responsibility for seeing the client timeously should this happen (although therapists are encouraged to do their own ward rounds daily to pick up missed patients).
-All referrals are written (no verbal ones please)
-Therapy assistants in charge of the particular ward should collect all new referrals in the morning and notify the relevant therapist the same day by giving them the referral. Therapists and assistants will then assess the patients together in the ward and decide on treatment plans. Patients will then be allocated to therapist and assistant.
-Ambulant patients can be fetched by an assistant and taken for treatment in the therapy department, non-ambulant ones are seen in the wards.
-Therapy treatments start at 09h00, ending at 16h30, and can happen during tea and lunch if the patient requires retraining of eating and drinking.
-In the case of non-ambulant patients, nursing staff must make sure the patient is:
- dry
- XR easily accessible
- oxygen units, suction equipment and nebulization equipment is
readily available.
- therapy is alerted when relatives come, and the client is not
discharged until they have seen therapy with their relatives (Put up the ‘pols visit Therapy’ sign above the patients bed for their relatives, and staple a D/C via Therapy sticker into the front of their file).
-Therapists write a CRF referral form in duplicate in the CRF book and will follow up wrt the home visit verbally at the end of the month. Should the patient still not have been visited, they will notify the HOD.
WITHIN THE WARD
-A written note should appear in the patients file regarding your referral (time, date, with whom and how). Notify the relevant person verbally of your referral (eg doctor on a round). If it is a referral to social work, psyche or AIDS etc, fill in the relevant referral form and hand it to them personally.
-Referrals within our team: these should be written, as for any other section. Follow them up during the Monday ward review meeting.
EXTERNAL REFERRALS:
Orthopeadics
-Refer to NGZ ortho clinic on Wed or Fri
-They need a bus ticket and a referral letter
-Send with XR if possible
Rhematology
-needs bloods and XR before they go, take results with
-must be referred by a doctor, booking in advance
-needs bus ticket and doctors referral letter
Neurology
-to IALCH, may need investigations before hand
-booking made by doctor, referral letter and bus ticket organized by doctor
Brachial Plexus Clinic
-at GreysHospital in PMB from 11h00-12h00 on very specific days, run by Dr Senoge
-phone and book in advance, send with referral letter
-needs to go with EMRS ambulance so phone Jozini EMRS a week in advance and take the details of the clerk making the booking, stress that the clinic is at 10h00, so they need to leave Manguzi at no later than 03h00. Stress that if he arrives late and is not seen, you will take the matter further with their management.
Hands clinic
-room 50 at KEH. Phonje and book in advance, write referral letter
-goes with usual bus
Psychology
-second Wednesday of the month at Manguzi. Booking essential- list in Therapy on wall.
-Emergencies, or those requiring lengthy psychology can be booked into Townhill in PMB (get EMRS ambulance to transfer them) after organizing with psychology there
IQ testing
-ONLY for those of school going age (6-12)
-Try to limit referrals to the once monthly Manguzi clinic and try to send them to NPA psychology- booking needed, OT assessment needed 9subject to change)
-Go with usual bus- need bus ticket
Special schools
-needs OT and psychology assessment and recommendation first
-decide which particular school will suit the child best and inform mother and refer to social work
-OTs organize placement, refer parents and child to clinic support group (new)
-once placement secured, child to come back for filling of CDG to pay for special school
-organize with AMS or mercy air to fly mother and child to the school for an interview and to see the school for mothers approval. Liaise with principal.
-follow up child closely to make sure gets into the school
-organize with Sunette from Mseleni that the school bus will pick child up at beginning of term- coordinate with mother (see particular protocols)
Pressure garments
-we make them
Spinal clinic
-doctor organizes booking at King George
-tests and XR to be done before hand, sent with referral letter on usual bus with bus ticket
-NB this is for serious spinal with severe neurological fallout, not general orthopeadics
MJD clinic
-every Friday at Mseleni from 10h00
-patients who have not been operated on before need to have XR taken the day before. Those with THR can have XR at Mseleni
-patients arrive on our bench at 07h30, ready with XR to leave with EMRS bus.
-When they return, check written recommendations in cards
-Those for elective THR will need bloods, dental before, and will arrive to leave on a Monday- this needs to be booked in advance with EMRS local. (NB: no more THRs due to budget constraints!!!!!)
Orthotics clinic and WentworthHospital
-Ortho clinic every 4th Wed of the month at Manguzi Therapy from 10h00
-Assistant allocated to help at clinic, fill in ortho forms and get them signed
-Therapist allocated to fax signed forms off the next day and file them
-Patients to be on our bench by 08h00
-If there is an urgent case that cannot wait 2 months to receive orthotics, send them down on the bus any day of the week with a referral letter, a signed orthotics form, and a bus ticket to Orthotics/Prosthetics dept at WWH (see protocol)
ENT clinic
-every 4th Monday of the month at Manguzi- booking list with audiologist and at OPD with the doctors
-see referral criteria in audio file
-audiologist assists by doing testing at this clinic
-doctors organize nurses, lunch and equipment
CT/MRI
-booked by doctor to NGZ
-needs to go with XR
-needs bus ticket and referral form
Audio special testing eg ABR
-at IALCH, booking by our audiologist needed
-goes with bus ticket and referral letter on regular patient bus