It’s approaching 5pm at your general practice and your well appointment isn’t doing so well after all; you’re an ER doc at the end of a 12-hour shift and luck has it that the last patient you pick up requires a service your hospital doesn’t have staffed; a good Samaritan brought in a hit by car in need of major stabilization to your shelter.
Whatever the case may be, we’ve all been there: a pet arrives whose medical needs surpass what we can provide.
Whether you’re a new grad dealing with your first case transfer to another facility or a seasoned veteran with excellent local referral relationships, here are 5 tips to set up your patient, your clients, and all clinical parties for success.
Tip #1: Call ahead
Step 1 in a seamless case transfer is to call ahead, even before the patient leaves your clinic. While it may seem intuitive, calling ahead is the most fundamental (and sometimes overlooked) step to ensure that your client is happy and your patient gets care in a timely manner.
With nationwide staffing shortages, long waits at the ER, and even hospital closures, calling ahead allows you to gauge a hospital’s ability to accept incoming cases, availability of services, and wait times. These factors are especially important if you live in an area that does not have abundant specialty and after-hours care.
Nothing will lead to a disgruntled client and, most importantly, interruption of patient care more than recommending lengthy travel to a hospital that ultimately cannot treat your patient.
Tip #2: Vet-to-vet communication is key
You’ve identified that your patient needs additional care, you’ve called the transfer clinic, and they can take your case; who should you speak to next?
Step 2 of successful case transfer is communicating with another veterinarian. While it may not always be possible to connect directly, vet-to-vet communication allows information to be transferred accurately and efficiently.
Speaking with the receiving veterinarian not only permits you to succinctly discuss the case at hand, but it also helps temper expectations for the client by gleaning what medical and financial recommendations may be made once the pet arrives at the next clinic.
Reporting back to your client with an actionable plan from a fellow veterinarian and a general cost estimate of services instills a sense of ownership in their pet’s care and encourages them that all parties are working together for the good of their pet.
Tip #3: Send records
After establishing a plan and ensuring everyone is on the same page, step 3 of a smooth case transfer is sending records.
Depending on your records system and the urgency with which the patient needs to be transferred, these can be digital or printed copies. While complete records are always appreciated, the most important documents that should be sent with the client or directly to the next clinic as soon as possible should be any and all diagnostics performed that day, as well as records from at least the last 12 months (or longer, depending on how chronic the illness is).
Always helpful to any clinician are bloodwork, radiographs, and other serial diagnostics performed previously so that the new attending clinician can compare trends.
This step requires direct communication with your support staff to ensure that records are sent in a timely manner; this is essential if case transfer is occurring around closing time to avoid the patient arriving at the new clinic with no way to retrieve records until the next business day.
Tip #4: Follow-up
Step 4 in stellar case transfer involves establishing grounds for follow up among all parties.
Our obligations to our patients and clients do not stop once the pet has left our doors; many times, clients will want our opinions on recommendations made at the referral practice, we will want an update on how our patients are doing, or the new attending clinician may want to touch base about ongoing care.
As the referring veterinarian, be up front about your availability once the patient has transferred: Will you be in office to answer lingering questions over the next few days? Can you perform rechecks, or would you like the referral practice to handle long-term care?
And as the receiving veterinarian, make it clear whether your hospital will be providing daily updates to the client or to both the client and referring veterinarian, as well as when the referring veterinarian should expect records (Daily? After discharge?).
Eliminating cracks in communication will provide comfort to the client that the team is well-oiled, and it will smooth out the sometimes-bumpy transition from acute to long-term care.
Tip #5: Know you did your best!
The final step when transferring a case is to cut ourselves some slack. As much as we may fool ourselves, perfection doesn’t exist, and we can’t beat ourselves up if something went wrong in the transfer process.
Technology, weather, emotions, and biologic systems are all things that many times operate beyond our control and can play a role in a difficult case transfer. As long as we have been transparent with our clients, opened up the lines of communication with our fellow veterinarians, and treated our patients with compassion, we have done our best.
Any other tips you’d add to this list? Drop us a note and let us know.
Jessica Nord, VMD is an Associate IndeVet practicing in South Carolina.