The consultation and referral process - A report from NEON
outcomes; communication; General & Internal Medicine; physicians; primary care; rates; information; patterns; family practice; continuity of patient care; family practice; general-practitioners; interprofessional relations; physician practice patterns; referral and consultation; specialist
BACKGROUND. Consultation and referral are essential components of the practice of primary care. Despite this, little is known about the factors that contribute to the success of a referral. We examined the short-term outcomes of communication between family physicians and consultants during the referral process. METHODS. The study setting was six family practice centers in northeastern Ohio. All eligible physicians at each center participated in data collection by means of a card study. Data was recorded on any patient who received a referral to a physician or nonphysician provider during the month of July 1994. One year later, referrals were followed up by physician questionnaire. RESULTS. Three hundred nine of 5172 total patients were referred (5.97 referrals per 100 office visits). At follow-up, the family physicians reported that 63% of patients had visited the consultant, 14% had not, and the physician had no knowledge of the actions taken by the other 23%. The referring physician received feedback from the consultant regarding 55% of the patients referred. Receipt of feedback was strongly related to communication by the family physician to the consultant at the time of referral. Physicians who received feedback were the most satisfied with communication from the consultant and the care their patient had received. CONCLUSIONS. Primary care physicians can influence the likelihood of receiving feedback from a consultant by initiating communication with the consultant. A referral wherein the physicians involved do not communicate with one another results in physician dissatisfaction. Primary care physicians must practice strategies to improve the referral process.
Bourguet C C; Gilchrist V; McCord G; Grp Neon Res
Journal of Family Practice
1998
1998-01
Journal Article or Conference Abstract Publication
n/a
Common eye disorders: six patients to refer. Symposium: first of two articles on eye disorders.
Referral and Consultation; Education; Emergencies; Case Studies; Eye Diseases; Continuing (Credit)
Thorough ocular history taking and physical examination are essential to establish a diagnosis in patients presenting with eye conditions. Some conditions require ophthalmologic referral to avoid serious complications and even vision loss. These include corneal ulcers, retinal detachment, iritis, glaucoma, retinal artery occlusion, and endophthalmitis. Because primary open-angle glaucoma can have an insidious onset and cause irreversible damage, funduscopic examination should be a part of every complete physical examination.
Weinstock F J; Weinstock M B
Postgraduate medicine
1996
1996-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Taking the mystery out of low back pain: diagnostic strategy yields clues for initial treatment and referrals...this is the first in a special series of articles on evaluation and management of back pain
Referral and Consultation; Intervertebral Disk Displacement; Low Back Pain – Therapy; Low Back Pain – Diagnosis; Low Back Pain – Epidemiology
Low back pain (LBP) is a significant public health problem that frequently restricts patient activity and boosts health care costs. LBP is also a vexing clinical problem. Although it is usually associated with specific work and social factors, in most cases the precise cause of pain cannot be determined. As a result, approaches to diagnosis and treatment are often ill-defined and inconsistent. A clear strategy for diagnosis of commonly seen LBP problems can lead to more effective initial treatment and referrals. This strategy places LBP problems in 1 of 4 general diagnostic categories: disk herniations, spinal canal stenosis, diskogenic LBP, or severe nonmechanical LBP Specific initial treatment and referral recommendations are made for each category.
Weiner B K; McCulloch J A
Journal of Musculoskeletal Medicine
2000
2000-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Linking the elderly to community services.
Humans; Ohio; Aged; Emergency Medical Services/*organization & administration; Referral and Consultation; Interinstitutional Relations; *Social Support; Community Health Services/*organization & administration; Forms and Records Control; Health Services for the Aged/*organization & administration; Organizational Innovation
Sometimes, the only contact elderly patients have with outside medical services is through the EMS network. Find out how one city uses prehospital providers to link these patients with community services tailored to their needs.
Gerson L W; Hoover R; McCoy S; Palmisano B
JEMS : a journal of emergency medical services
1991
1991-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Improving Chronic Disease Outcomes Through Medication Therapy Management in Federally Qualified Health Centers.
*Quality Improvement; Adolescent; Adult; Aged; Antihypertensive Agents/*therapeutic use; Blood Pressure; Chronic Disease – Drug Therapy; Chronic Disease – Therapy; community health centers; Community Health Centers; Data Analysis Software; Descriptive Research; Descriptive Statistics; Diabetes Education; Diabetes Mellitus – Therapy; Diabetes Mellitus/*drug therapy/metabolism; Female; Financing; Funding Source; Glycated Hemoglobin A/metabolism; Glycosylated; Government; Health Services; Hemoglobin A; Hospital/*methods; Human; Humans; Hypertension – Therapy; Hypertension/*drug therapy; Hypoglycemic Agents/*therapeutic use; Male; Medically Underserved; Medication Management; medications; Middle Aged; Multicenter Studies; Ohio; Outcome Assessment (Health Care); Outcomes (Health Care); Patient Education as Topic; Pharmacists; pharmacy; Pharmacy Service; Pilot Projects; Pilot Studies; primary care; program evaluation; Prospective Studies; Referral and Consultation; Self Care; Young Adult
INTRODUCTION: Appropriate management of chronic diseases, including proper use of medications, can lead to better disease control, decrease disease-related complications, and improve overall health. Pharmacists have been shown to positively affect chronic disease outcomes through medication therapy management (MTM). The primary objectives of this project are to increase the number of patients with (1) A1c in control and (2) blood pressure in control; secondary objectives are to (3) describe number and type of medication-related problems identified and resolved by pharmacists providing MTM in Federally Qualified Health Centers (FQHCs), (4) identify potential (pADEs) and actual adverse drug events (ADEs), and refer patients to diabetes self-management education classes, as needed. METHODS: This multisite, prospective, descriptive pilot study engaged three FQHC sites with distinct models of established pharmacist MTM services to care for patients with uncontrolled diabetes and/or hypertension. Data were reported in aggregate regarding primary and secondary outcomes. RESULTS: As of December 2015, 706 patients were enrolled in the project. Of the 422 with uncontrolled diabetes, 52.84% (n = 223) had an A1c \textless9%; 72 patients (17.06%) achieved an A1c between 8% and 9%, 19.19% (n = 81) of patients achieved an A1c \textless8% and \textgreater/=7%, and 16.59% (n = 70) of patients achieved an A1c \textless7%. The percentage of patients with blood pressure \textless140/90 mm Hg improved to 65.21%. CONCLUSION: Pharmacist-provided MTM can improve chronic disease intermediate outcomes for medically underserved patients in FQHCs.
Rodis Jennifer L; Sevin Alexa; Awad Magdi H; Porter Brianne; Glasgow Kyle; Hornbeck Fox Carrie; Pryor Barbara
Journal of Primary Care & Community Health
2017
2017-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/2150131917701797" target="_blank" rel="noreferrer noopener">10.1177/2150131917701797</a>
Common eye disorders: six patients to refer.
Adult; Aged; Angle-Closure/diagnosis/therapy; Corneal Ulcer/diagnosis/therapy; Eye Diseases/*diagnosis/*therapy; Female; Glaucoma; Humans; Iritis/diagnosis/therapy; Male; Referral and Consultation; Retinal Artery Occlusion/diagnosis/therapy; Retinal Detachment/diagnosis/therapy
Thorough ocular history taking and physical examination are essential to establish a diagnosis in patients presenting with eye conditions. Some conditions require ophthalmologic referral to avoid serious complications and even vision loss. These include corneal ulcers, retinal detachment, iritis, glaucoma, retinal artery occlusion, and endophthalmitis. Because primary open-angle glaucoma can have an insidious onset and cause irreversible damage, funduscopic examination should be a part of every complete physical examination.
Weinstock F J; Weinstock M B
Postgraduate medicine
1996
1996-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/00325481.1996.11946100" target="_blank" rel="noreferrer noopener">10.1080/00325481.1996.11946100</a>
What do we know about rhinogenic headache? The otolaryngologist's challenge.
Contact point headache; Cooperative Behavior; Diagnosis; Diagnostic Imaging; Differential; Headache – Diagnosis; Headache – Etiology; Headache/diagnosis/*etiology; Humans; Interdisciplinary Communication; Interprofessional Relations; Medical History Taking; Migraine – Diagnosis; Migraine – Etiology; Migraine Disorders/diagnosis/*etiology; Migraine headache; Nasal pain; Neurologic Examination; Paranasal Sinuses – Pathology; Paranasal Sinuses/pathology; Patient History Taking; Primary Health Care; Referral and Consultation; Rhinitis – Complications; Rhinitis – Diagnosis; Rhinitis/*complications/*diagnosis; Rhinogenic headache; Sinus headache; Sinusitis – Complications; Sinusitis – Diagnosis; Sinusitis/*complications/*diagnosis
Sinus headache is a common presenting complaint in the otolaryngology office. Although most patients with this presentation are found to have migraine headache, many do not, and others fail therapy. This review focuses on the current understanding of nonneoplastic rhinogenic headache: headaches that are caused or exacerbated by nasal or paranasal sinus disease or anatomy. The literature regarding this topic is reviewed, along with a review of surgical series seeking to correct these abnormalities and the outcomes obtained with intervention. Suggestions are provided regarding patient diagnosis and management, and options for intervention are reviewed.
Mehle Mark E
Otolaryngologic clinics of North America
2014
2014-04
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.otc.2013.10.006" target="_blank" rel="noreferrer noopener">10.1016/j.otc.2013.10.006</a>
Behavioral Health and Primary Care Integration in Ohio's Psychiatry Residency Training.
*Internship and Residency; Delivery of Health Care; Education; Graduate; Health Care Delivery; Humans; Integrated; Internship and Residency; Medical; Mental Health Services – Administration; Mental Health Services/*organization & administration; Ohio; Physician's Role; Primary Health Care – Administration; Primary Health Care/*organization & administration; Psychiatry; Psychiatry – Education; Psychiatry/*education/organization & administration; Qualitative Research; Qualitative Studies; Referral and Consultation
Reed Eric; Crane Dushka; Svendsen Dale; Herman Lon; Evans Brian; Niedermier Julie; Resch William; Ronis Robert; Varley Joseph; Welton Randy
Academic psychiatry : the journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry
2016
2016-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s40596-016-0623-y" target="_blank" rel="noreferrer noopener">10.1007/s40596-016-0623-y</a>