Intent of this requirement
Organisations that provide care and services are expected to consult with the consumer and make appropriate referrals to other individuals, organisations or providers that can provide a care and services that meets the consumer’s needs. This is to make sure that the care and services meet the consumer’s needs, goals and preferences and improves their health and well-being.
After finding out what a consumer’s needs, goals and preferences are for independence, health and well-being, an organisation may decide that specialist providers will be better able to give the consumer the particular care they need. Specialist services can include allied health, hearing, dental, medical or psychiatric services or other specialised therapy services.
Having an active network of other individuals, organisations or providers, they can refer or collaborate with, means the organisation can meet the diverse needs of consumers. It is expected that organisations do this in line with the Quality of Care Principles, 2014.
Organisations will need to meet obligations relating to privacy of information when co-ordinating care with other providers, organisations or individuals.
- How has the organisation identified individuals, organisations or providers that can deliver care, services and supports to better meet consumer choices?
- When more than one organisation is responsible for a consumer’s, is it clear to everyone who is responsible for providing personal or clinical care at any point in time?
- If their condition deteriorates, what services may the consumer need that can’t be safely managed within the organisation? What systems does the organisation have to make timely referrals, if this is in line with the consumer’s preferences?
- What are the organisation’s barriers to timely referrals and does it actively work to remove these barriers?
Examples of actions and evidence
- Consumers say that where the organisation has been unable to provide suitable care they have helped organise someone else to provide it.
- Consumers say the organisation has referred them to the appropriate providers, organisations or individuals to meet their changing personal or clinical care needs.
- Consumers believe referrals happen promptly when their personal or clinical needs change.
- Consumers say they are satisfied with the care delivered by those they’ve been referred to. They also say the care from the other individuals, organisations or providers are delivered in a culturally safe way.
Workforce and others
- The workforce can identify other individuals, organisations or providers they can make referrals to and any referral criteria that applies.
- The workforce can describe how they refer consumers to other individuals, organisations or providers and how they collaborate to meet the diverse needs of consumers.
- The workforce can describe how the consumer is actively involved in decisions and about referrals and how consent is obtained.
- Workforce orientation, training or other records that show how the organisation supports the workforce to meet this requirement.
- The organisation’s strategic and operational planning describes activities that maintain a network of individuals, organisations or providers they can refer consumers to.
- Evidence that the organisation has links with other individuals, organisations or providers to make sure consumers can access a range of care and services, for example memorandums of understanding.
- Policy documents for referrals to other individuals, organisations or providers that include arrangements for services that the organisation doesn’t provide. This includes contacts, roles and responsibilities of the workforce when making referrals, and involving consumers and their representatives.
- Consumers’ care and services plans show that the organisation collaborates with other individuals, organisations or providers to support the diverse needs of consumers.
- Records that show the organisation regularly reviews the individuals, organisations or providers they refer consumers to, to make sure their services remain safe and effective and quality care and services are being delivered.
- Consumer records show the organisation makes timely referrals to health practitioners, specialised allied health, or other services, to meet the care needs of consumers.
- Evidence of referral processes, outcomes for consumers, and projects that show quality improvement.