Mitigating Risk When Referring Patients
Treating patients successfully and without error requires seamless communication–lacking or incomplete information can result in missed or delayed diagnoses, patient injuries and subsequent malpractice claims. To mitigate this risk, establish a system that ensures that requests for consults, studies and other referrals include sufficient, comprehensive information and that critical results are acted upon in a timely manner. A lack of clearly defined roles and responsibilities throughout the process can impede a facility’s ability to provide and promote safe patient care.
Ways of Mitigating Risk
To minimize the risk of error relating to patient referrals, consider the following guidelines:
- Encourage face-to-face or telephone conversations between referring and consulting physicians to clarify contents of a report if necessary.
- Clearly establish the responsibilities of both parties when communicating results.
- Document each exchange thoroughly.
- Require a provider to initial and date (or electronically sign) all consultation reports before filing them in a patient’s medical record.
Referring physicians should be encouraged to follow up on all cases they refer. When referring patients, the referring physician should remind the consultant of respective roles and responsibilities. To ensure that every patient is accounted for, take the following steps:
- Develop a method for alerting the referring physician when a consultation has been completed and whether a written report has been received.
- Require referring physicians to contact consultants when a written report is missing.
- Require information regarding the patient to be included with the letter of referral, including:
o The reason for the referral
o Patient history and diagnostic studies performed
o Specific definition of expectations
o Contact information and request for follow-up
Consulting physicians should send timely written reports to referring physicians. Reports containing critical results should be clearly marked and should include the following:
- Recommendations, including interventions and the delineation of provider responsibility for treatment
- Follow-up of abnormal test results, including incidental findings
Consultants should also contact referring physicians when patients fail to keep appointments, and document the notification.
For more information on managing risk and securing coverage in health care facilities, contact Jimmy Porrello, Chief Operations Officer at Kaercher Insurance.