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Ethiopia MSD - Patient Referral System Implementation Guideline

This document provides guidelines for implementing an effective patient referral system in Ethiopia's tiered health system. It defines referral, outlines roles and responsibilities, and describes the typical flow of patients. Key aspects of managing the referral system include having coordination units, standard referral forms, directories of services, and ensuring a feedback loop. Referral is a two-way process that aims to provide continuity of care and make efficient use of resources. Monitoring the system involves assessing referral rates, acceptance of referrals, and using data to improve coordination across different levels of care.

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Benarivo Triadi Putra
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4K views22 pages

Ethiopia MSD - Patient Referral System Implementation Guideline

This document provides guidelines for implementing an effective patient referral system in Ethiopia's tiered health system. It defines referral, outlines roles and responsibilities, and describes the typical flow of patients. Key aspects of managing the referral system include having coordination units, standard referral forms, directories of services, and ensuring a feedback loop. Referral is a two-way process that aims to provide continuity of care and make efficient use of resources. Monitoring the system involves assessing referral rates, acceptance of referrals, and using data to improve coordination across different levels of care.

Uploaded by

Benarivo Triadi Putra
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Patient referral

implementation guideline

content
Defining referral
Referral system work flow
Roles and responsibilities
Management of the referral system
Typical patient flow
Accountability
Monitoring and evaluation

Ethiopian health tier system


Specialized
Hospital
3.5 5.0

Tertiary level health care

Million
General hospital

Secondary level health care

(1000000-1500000) people

Primary hospital

Health
center
40000

60000-100000
Health center
15000-25000
Health post
3000-5000

Urban

Rural

Primary level
health care

Defining referral
Referral is a process by which a health
worker/facility transfers the responsibility of care
to another health worker/facility or social
worker .
Two way process and ensures continuum of care
Referral can be vertical, horizontal or diagonal
Public, private ,community based ,traditional and
alternative medicine practitioners

Tertiary care
specialized
hospital
Public/private

Community

Secondary
care General
Hospital
Public/private

Community

based care

Health Post

Primary
care

Health Center

Private Clinic
Primary Hospital

Intro.
Rationale :continuum of care
Benefits of good referral system:
-increases the efficiency and effectiveness
of the health system
-strengthens peripheral health facilities and
improves decision making capacity at
lower levels
-promotes cooperation and
complementation between the three
levels of care

Elements of a referral system


Group of organizations
Coordinating units
Focal persons/liaison officers
Directory of services
SOPs
Standard referral form
Feed back loop
Documentation

Content of service directory


General information of health facility
Addresses of CEOs and MDs
Liaison officers contact details
Type of health professional available
Type of service provided-clinical &
diagnostic
Weekly schedule of specialty cases

Reasons for referral


Medical

and in the interest of the patient

Expert advice
Technical examination
Technical intervention
Care beyond the facilitys capability
Unavailability of resources

roles and responsibilities


Referring

health worker

knows what, where and when to refer


Fills referral form and attach documents
Explains to patient-reason, preparation,
cost ,expected out come
Answers queries from liaison officer or
receiving facility
Secures result of referral

Roles contd
Receiving

health worker

Responds promptly to consultation


requests
Feed back with all required information
Communicates with the patient findings
Not to undermine referring worker by
any means

Roles and responsibilities


Referral

coordinator/liaison officer

Responsible for both referrals in and out


Facilitates scheduling by using
communication methods like tele..
Ensures availability of service at receiving
end
Facilitates transportation for emergency
cases
Keeps referral registry

Role and
Referring

facility

Ensures staff awareness


Continuous supply of referral form
Keeps directory of health facilities
Ensures recording of referral activities
Devises mechanisms to track referral
Provides transport to emergency cases
Assigns referral coordinator/liaison officer

Role and
Receiving

facility

Assigns referral coordinator


Ensures staff at point of entry understand
referral process
Ensures referred patients are seen by
appropriate professional
Considers attached investigations
Ensures prescheduled referrals are seen
without delay
Devises follow up plans

Management of referrals
Facility level
Regional and woreda levels
FMOH level

Management contd
Facility

level

Referral coordinator coordinates all referral


activities
Records, compiles, analyzes and interprets
referral data
Arranges regular review meetings within and
outside health facility
Supportive supervision
Ensures feed back is sent

Regional health bureaus


Equip health facilities as per standard
Assign referral coordinating unit
Prepare regional service map and directory
Referral SOPs
Community awareness
Priority to emergency without any
restriction
Regional registry
Regular meetings to analyze and take
measures

FMOH
Assigns referral focal unit
Initiates legislation, policy as necessary
Sets standards for health facilities
Capacity building
Monitoring and coordination at national level
Revision and updating the document as
necessary
Assists regions with preparation of directory

Typical patient flow

Typical referral patient flow.doc

Accountability
Monitoring mechanism by RHB and
FMOH
Legislation
By pass fee
Queuing system
Public education and communication
Equipping health facilities as per the
standard and building public confidence

Monitoring and evaluation


Referral rate
The number of referrals per 100 new
patients
Acceptance and compliance of referrals

THANK YOU

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