Protocol of Referral to Paamcc

Protocol of Referral to Paamcc

Saturday, May 05, 2012

PROTOCOL OF REFERRAL TO PAAMCC

As PAAMCC is the only TertiaryCardiacCenter in the North Region and serving more than 250, 00populations with a limited number of beds. So this policy is implemented for the best use of the facilities available in the center like Cath lab., O.R., CT , ect .

As an initial step the Center will be ready to accept patients referred from all hospitals of the region according to the following rules:

  1. OUT PATIENT
  • All adult patients who have cardiac disease and need second opinion or Consultant’s opinion will be accepted in OPD according to appointment given by OPD Coordinator. The referring Physician initially will send fax or request including full medical report typed and with full data like history, clinical examination, laboratory and radiology results and cause of referral.
  • As PAAMCC did not yet start the pediatric cardiology program, all pediatric cases who need cardiology opinion should be referred either directly to other centers or to Pediatric Department in ArarCentralHospital.
  • Patients who need special investigations not available in the referring hospital can be referred with a fax or request for that particular investigation (Echo, TEE, TMT, Holter, CT)
  • Appointment for that request will be sent to the referring hospital with the instructions needed. The referring physician should explain the procedure and the pre procedure instructions to the patient before sending him especially for those who are far away from Arar.
  1. IN PATIENT
  • Patients who needCoronary Care Unit e.g. , STEMI, ACS, cardiac tamponade , C.H.B., newly diagnosed heart failure, Or who need interventions like CAG, PCI, CABG, pericardiocentisis or pacemaker will be accepted in our center. (Provided bed is available )
  • Patients who have contraindications to the above mentioned procedures and in home medical treatment is more suitable to the patients like patients in severe co morbidityor low functional capacity or advanced pulmonary, kidney, liver or neurological disease or malignancy should be managed in the local hospital and will not be accepted in PAAMCC. And the treating Physician whether Cardiologist or Medical Specialist can always seek over phone advice from the on call Specialist or Consultant.
  • Known case of cardiac problem who have been previously diagnosed and planned on medical treatment, if admitted due to decompensation or non compliance or other co morbidities, still can be managed in the local hospital in General ward or ICU by Cardiologist or Medical Specialist and if urgent intervention is needed and no contraindications, they will be accepted in PAAMCC.
  • At present, PAAMCC did not start Pediatric Cardiology, electrophysiology or device therapy. So the patient who needs any of the above mentioned services should be referred directly to the concerned centers.
  • In all cases the safety of the transferred patient is the responsibility of the referring Physician, so the referring hospital should take all the precautions to ensure safe transportation of the patients.
  • Direct communication between the referring physician and the oncall physician in PAAMCC can solve lot of problemsand misunderstandings so we encourage all

referring physicians to try to call the oncall physician or to include his contact number in the referral so our team can contact them. And the medical director

secretary office in PAAMCC will fax the monthly duty Rota to all concerned hospitals including the contact number of the oncall specialists and consultants.

  • Clear, typed, referral report including all needed data is very important and helps to save time and effort.( look to the attached referral form )
  • True age of the patient is very important for the decision making, as many procedure and medications is not safe in older age group.
  • The referring hospital should accept back the patient after the end of the procedure.
  • Feedback to the primary referring physician is very important, So PAAMCC will provide each patient with clear typed discharge summary including the diagnosis, details of hospital stay, results of important investigations and procedures,treatment, and next plain of management.A copy of this discharge summary will be faxed to the referring physician. And in case of loss, a copy can always requested and retrieved from our data base system upon request.
  • We in PAAMCC are open minded and ready to listen to any suggestion or comment as long as it will help to improve our service and the patient care, and the protocol can always be changed and updated upon mutual agreement and if any new procedure or new subspecialty is added to our service

Medical Director General Director

Dr. Yosri M. A. Morsi Dr. Mohamad A. Alhabdan

REFERRAL FORM

NAME OF PATIENT: / CONTACT NUMBER:
AGE : SEX:
NATIONALITY:
MRN:
REFERRING HOSPITAL: / CONTACT NUMBER:
REFERRING PHYSICIAN: / CONTACT NUMBER:

DIAGNOSIS

Brief history and hospital course

Past medical history and comorbidities(like renal failure, stroke, COPD, surgical procedures, etc..)

Functional status of the patient

Clinical assessment

Investigations:

*CBC, * KFT, * electrolytes, * LFT, *coagulation profile, *cardiac enzymes, * lipid profile

*ECG, *ECHO

Previous investigations like Echo, C.A.G., PCI, CABG, valve surgery

Current medications

Cause of referral

  • For patients whoare referred for the any procedure, it is the duty of the referring physician to explain the procedure, risk and precautions to the patients.
  • Contact number of PAAMCC : 04 662 0614 ext: Fax/478.Reception 00.CCU/222. ROD/204. Medical Director 04 662 7209

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