Page 40 - 2021 Risk Reduction Series - Communication Part One

SVMIC Risk Reduction Series: Communication

died. According to the report, the goal is to create a closed-
11
loop referral process. This is one in which all patient data
and information that require action are communicated to the

right individuals at the right time through the right mode of
communication to allow for review, action, acknowledgment,

and documentation. Simply stated – physicians need a highly
reliable referral process that ensures the patient doesn’t fall

through the cracks. There are unique hurdles in an outpatient
referral system versus the hospital consultation system. In the

hospital, a consult is ordered, and typically, the specialist is at
the bedside within the day. Outpatient treatment is often chronic

and unfolds slowly, so completing the referral process takes
longer.

Many physicians have a referral system that fails to close the

loop because the patient didn’t keep the appointment. This is
frustrating for the physician, especially in the face of screening

guidelines that may be more challenging to effectively track.
Patients may consider these tests “optional” and frequently

cancel appointments. In addition to having a process for
handling missed appointments (discussed earlier in this course),

it is important to regularly review and evaluate your practice’s
referral process. The referral process should include a shared

decision-making conversation in which both the physician and
patient agree to the plan. There is a critical difference between

a patient who refuses to go and one who misunderstands the
need for the referral and potential consequences of failure to

keep the appointment.

11 http://www.ihi.org/resources/Pages/Publications/Closing-the-Loop-A-Guide-to-Safer-
Ambulatory-Referrals.aspx

Page 40