WINN Army Community Hospital Referral Guidelines
Championed by LTC David Anderson, General Surgeon, LTC Karin Johnson, Orthopedic Surgeon and LTC Richard James, Dermatologist, WINN Referral Guidelines are being made available to facilitate the process of referral from primary care to specialty care. These guidelines can also be used as a tool to ensure better use of resources by adjusting the threshold for referral, depending on specific types of care.
It should be stressed that the WINN Referral Guidelines are only tools. The ultimate judgment regarding the appropriateness of any specific therapy or referral must be made by the physician in light of all circumstances presented by an individual patient.
WINN Referral Guidelines are uniformly formatted to include:
- Diagnosis/Definition
- Initial Diagnosis and Management
- Ongoing Management and Objectives
- Indications for Specialty Care
The care provider may use these guidelines to help determine the best approach for treatment of patients, as well as when to refer to a specialist. These guidelines should be consulted prior to placing a referral. In most cases when the referral does not document care in accordance with these guidelines, it will be returned and there will be a delay in the patient being seen. If the patient’s diagnosis meets the criteria for specialty care referral, then strong consideration should be given for consultation with the appropriate specialty care clinic.
When placing a specialty referral, here are a few tips to remember:
- The “Provisional Diagnosis” must match the “Reason for Consult”.
- The “Reason for Consult” must have concise information — For example, provide more than “knee pain” but don’t cut and paste the entire MRI report or the patient’s exam.
- Key elements to include: age, presumptive diagnosis, status (AD, WTU, FM, etc), treatment performed to date and outcome, imaging studies or labs obtained.
- Include a clear statement of the goal of the consult — if the patient just needs a revision of a profile or clearance for deployment by a specialist, state that in the consult. If they’re unhappy with their previous provider and want another opinion, write that out clearly as well.
- Correct phone numbers and contact information.
- Follow the referral guidelines.
- Call WINN specialists with questions/concerns.
- If new imaging has been ordered, wait until that test is done before sending the patient to a specialist (An appointment is wasted when the results aren’t back from imaging or other studies).
- Include any dates the patient is unavailable to aid in booking. If they’re going to be gone for a prolonged period (over 30 days) for block leave or TDY, wait until after they get back to put in the consult.
- Avoid “shot-gunning” consults. Sending the patient to multiple specialists for the same condition often clouds the picture and leads to multiple treatment plans
