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Academic literature on the topic 'Referral system'

Author: Grafiati

Published: 4 June 2021

Last updated: 11 June 2025

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Journal articles on the topic "Referral system"

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Dennison, Jessica, Sarah Eisen, Matthew Towers, and Celia Ingham Clark. "An Effective Electronic Surgical Referral System." Annals of The Royal College of Surgeons of England 88, no. 6 (2006): 554–56. http://dx.doi.org/10.1308/003588406x130642.

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INTRODUCTION Electronic booking of out-patient appointments is being rolled out in England under the ‘Choose and Book’ programme. We set up and ran a local electronic surgical referral service before this. This paper assesses the effect of the electronic surgical referral service on patient waiting times and attendance rates. PATIENTS AND METHODS The study included 54 patients referred electronically and 189 referred on paper to a single colorectal surgical service over the same period. RESULTS The appointment booking was achieved on the same day as the referral was made for the majority of electronic referrals whereas it took an average of 7 days for paper referrals. There was no significant difference in the time from referral to being seen in clinic between the two groups. Patients referred electronically were much more likely to attend for their appointment. CONCLUSIONS This study shows that an electronic surgical referral system can improve efficiency. This may be because this system allows enhanced patient choice of appointment date and time.

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Shephard, Emma, Claire Stockdale, Felix May, et al. "E-referrals: improving the routine interspecialty inpatient referral system." BMJ Open Quality 7, no. 3 (2018): e000249. http://dx.doi.org/10.1136/bmjoq-2017-000249.

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Interspecialty referrals are an essential part of most inpatient stays. With over 130 referrals occurring per week at the Royal Devon and Exeter Hospital, the process must be efficient and safe. The current paper-based ’white card' system was felt to be inefficient, and a Trust incident highlighted patient safety concerns. Questionnaires reinforced the need for improvement, with concerns such as a lack of referral traceability and delays in the referral delivery due to workload. The aims of the project were to improve patient safety and junior doctor efficiency in the referral process. Through appreciative enquiry and the PDSA (Plan-Do-Study-Act) model, an electronic referral system was developed, piloted within two specialties and later expanded to others with improvements made along the way based on user feedback. The system includes novel features including specialties ’acknowledging' a referral to allow referral progress to be tracked. The system stores all referrals, creating a fully auditable inpatient referral pathway. Qualitative data indicated improvement to patient safety and user experience (n=31). Timings for referrals were measured over a 6-month period; referrals became faster with the electronic system, with average time from decision to refer to referral submission improving from 2.1 hours to 1.9 hours, with a noted statistically significant improvement in timings on a statistical process control chart. An unexpected benefit was that patients were also reviewed faster by specialties. Measuring these changes presented a significant challenge due to the complexity of the referral process, and this was a big limitation. Overall, the re-design of a paper-based referral system into an electronic system has been proven to be more efficient and felt to be safer for patients. This is a sustainable change which is being rolled out Trust-wide. We hope that the reporting of this project will help others considering reviewing their inpatient referral pathways.

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Al Shamsi, Hilal Salim, Abdullah Ghthaith Almutairi, and Sulaiman Salim Al Mashrafi. "Assessing the Quality of the Saudi Healthcare Referral System: Potential Improvements Implemented by Other Systems." Global Journal of Health Science 10, no. 11 (2018): 113. http://dx.doi.org/10.5539/gjhs.v10n11p113.

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INTRODUCTION: The referral system authorizes and transfers the responsibility for healthcare services from one provider to another. A key component of the system is the communication between primary-care and specialist providers. Poor communication between them is detrimental to and can cause significant issues with coordination of effective care.  OBJECTIVE: The purpose of this review was to evaluate current healthcare referral systems, focusing on the communication among providers, and to suggest practices that could make the Saudi healthcare referral system more effective.  DESIGN: This systematic review identified published studies of the quality of the healthcare referral system in Saudi Arabia and other countries using two databases, Medline and PubMed. Data were summarized and extracted into two tables.  RESULTS: The review included 12 studies that met its selection criteria. These studies were conducted in various regions of Saudi Arabia, but mostly the west and north. The 12 studies included 181,192 participants, with numbers of participants ranging from 21 to 138,484. The present review found that more than 50% of the referral documents and feedback reports in these studies had incomplete patient information. Implementation of electronic referrals (e-referrals) in several countries, including Australia, New Zealand and the United States, improved their referral systems, particularly by solving the problem of incomplete referral documents. In addition, the present review found that in some specialist clinics, referral cases contributed to increased workloads. One study reported on implementation of Lean Six Sigma principles in a military hospital in western Saudi Arabia, which reduced the number of referrals delayed, inappropriate referrals and the response time to referrals (7%). E-referrals and Lean Six Sigma principles may be applicable in Saudi Arabia as solutions to referral and response-time problems.  CONCLUSIONS: An increase in healthcare referrals in Saudi Arabia has caused an increase in missing essential information in referral letters and feedback reports as well as overcrowding in specialist clinics. The results of the present review suggested that implementing e-referral and Lean Six Sigma principles may improve the quality of Saudi Arabia&rsquo;s healthcare referral system.

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Kline, Teri A., and Donald R. Self. "The Referral System." Health Marketing Quarterly 6, no. 1-3 (1989): 117–24. http://dx.doi.org/10.1300/j026v06n01_06.

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Sweeney, B. "The referral system." BMJ 309, no. 6963 (1994): 1180–81. http://dx.doi.org/10.1136/bmj.309.6963.1180.

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Griffiths, C. H. "Draconian referral system." British Dental Journal 213, no. 1 (2012): 4–5. http://dx.doi.org/10.1038/sj.bdj.2012.566.

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Hendijani, Rosa, and Diane P. Bischak. "The effect of social relationships on the rates of referral to specialists." International Journal of Operations & Production Management 36, no. 4 (2016): 384–407. http://dx.doi.org/10.1108/ijopm-02-2015-0086.

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Purpose – In order to decrease patient waiting time and improve efficiency, healthcare systems in some countries have recently begun to shift away from decentralized systems of patient referral from general practitioners (GPs) to specialists toward centralized ones. From a queueing theory perspective, centralized referral systems can decrease waiting time by reducing the variation in the referral process. However, from a social psychological perspective, a close relationship between referring physician and specialist, which is characteristic of decentralized referral systems, may safeguard against high referral rates; since GPs refer patients directly to the specialists whom they know, they may be reluctant to damage that relationship with an inappropriate referral. The purpose of this paper is to examine the effect upon referral behavior of a relationship between physicians, as is found in a decentralized referral system, vs a centralized referral system, which is characterized by an anonymous GP-specialist relationship. In a controlled experiment where family practice residents made decisions concerning referral to specialists, physicians displaying high confidence referred significantly fewer patients in a close relationship condition than in a centralized referral system, suggesting that for some physicians, referral behavior can be affected by the design of the service system and will, in turn, affect system performance. Design/methodology/approach – The authors used a controlled experiment to test the research hypotheses. Findings – Physicians displaying high confidence referred significantly fewer patients in a close relationship condition than in a centralized referral system, suggesting that for some physicians, referral behavior can be affected by system attributes and will, in turn, affect system performance. Research limitations/implications – The current study has some limitations, however. First, the sample consisted only of family practice residents and did not have the knowledge and experience of GPs regarding the referral process. Second, the authors used hypothetical patient case descriptions instead of real-world patients. Repeating this experiment with primary care physicians in real setting would be beneficial. Practical implications – The study indicates that decentralized referral systems may act (rightly or wrongly) as a restraint on the rate of referrals to specialists. Thus, an implementation of a centralized referral system should be expected to produce an increase in referrals simply due to the change in the operational system setup. Even if centralized referral systems are more efficient and can facilitate the referral process by creating a central queue rather than multiple single queues for patients, the removal of social ties such as long-term social relationships that are developed between GPs and specialists in decentralized referral systems may act to counterbalance these theoretical gains. Social implications – This study provide support for the idea that non-clinical factors play an important role in referrals to specialists and hence in the quality of provided care, as was suggested by previous studies in this area (Hajjaj et al., 2010; Reid et al., 1999). The design of the service system may inadvertently influence some doctors to refer too many patients to specialists when there is no need for a specialist visit. In high-utilization health systems, this may cause some patients to be delayed (or even denied) in obtaining specialist access. Healthcare systems may be able to implement behavioral-based techniques in order to mitigate the negative consequences of a shift to centralized referral systems. One approach would be to try to create a feeling of close relationship among doctors in centralized referral systems. High communication and frequent interaction among GPs and specialists can boost the feelings of teamwork and personal efficacy through social comparison (Schunk, 1989, 1991) and vicarious learning (Zimmerman, 2000), which can in turn motivate GPs to take control of the patient care process when appropriate, instead of referring patients to specialists. Originality/value – The authors’ study is the first examining the effect of social relationships between GPs and specialists on the referral patterns. Considering the significant implications of referral decisions on patients, doctors, and the healthcare systems, the study can shed light into a better understanding of the social and behavioral aspects of the referral process.

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Pensuwan, Waraluk, Chukiat Viwatwongkasam, Pratana Satitvipawee, and Pichitpong Soontornpipit. "E-Referral System by Means of Decision Support System." Applied Mechanics and Materials 781 (August 2015): 587–90. http://dx.doi.org/10.4028/www.scientific.net/amm.781.587.

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This research aims to study, analyze, design and develop a web-based referral system for the recommendation of appropriate referred hospitals. Decision support system is applied to reduce time to find provider information that qualify with referral policy, medical specialists, bed, healthcare coverage, how emergency, distance and transportation time. This e-referral system scopes referral area from Siriraj hospital to other health care providers in Bangkok and metropolitan region (Nakhon Pathom, Nonthaburi, Pathum Thani, Samut Prakan and Samut Sakhon), with a total of 240 hospitals. This approach uses a rule-based system to match providers with Siriraj referral policy. Then, these matched providers’ data are analyzed to calculate its weight value.

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Ramelson, Harley, Amanda Nederlof, Sam Karmiy, et al. "Closing the loop with an enhanced referral management system." Journal of the American Medical Informatics Association 25, no. 6 (2018): 715–21. http://dx.doi.org/10.1093/jamia/ocy004.

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Abstract Objective To evaluate the impact of a referral manager tool on primary care practices. Materials and Methods We evaluated a referral manager module in a locally developed electronic health record (EHR) that was enhanced to improve the referral management process in primary care practices. Baseline (n = 61) and follow-up (n = 35) provider and staff surveys focused on the ease of performing various steps in the referral process, confidence in completing those steps, and user satisfaction. Additional metrics were calculated that focused on completed specialist visits, acknowledged notes, and patient communication. Results Of 1341 referrals that were initiated during the course of the study, 76.8% were completed. All the steps of the referral process were easier to accomplish following implementation of the enhanced referral manager module in the EHR. Specifically, tracking the status of an in-network referral became much easier (+1.43 [3.91–2.48] on a 5-point scale, P &lt; .0001). Although we found improvement in the ease of performing out-of-network referrals, there was a greater impact on in-network referrals. Discussion Implementation of an electronic tool developed using user-centered design principles along with adequate staff to monitor and intervene when necessary made it easier for primary care practices to track referrals and to identify if a breakdown in the process occurred. This is especially important for high-priority referrals. Out-of-network referrals continue to present challenges, which may eventually be helped by improving interoperability among EHRs and scheduling systems. Conclusion An enhanced referral manager system can improve referral workflows, leading to enhanced efficiency and patient safety and reduced malpractice risk.

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Petzel, Sue V., Rachel Isaksson Vogel, Jena McNiel, Anna Leininger, Peter A. Argenta, and Melissa A. Geller. "Improving Referral for Genetic Risk Assessment in Ovarian Cancer Using an Electronic Medical Record System." International Journal of Gynecologic Cancer 24, no. 6 (2014): 1003–9. http://dx.doi.org/10.1097/igc.0000000000000148.

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ObjectiveWe sought to evaluate an electronic referral form to increase referral for genetic risk assessment of women with newly diagnosed epithelial ovarian cancer.MethodsA form summarizing referral for genetic counseling for women with ovarian cancer was introduced into the electronic medical record allowing gynecologic oncologists to electronically submit a request for genetic services. Analysis compared patient and provider characteristics for women newly diagnosed with ovarian, fallopian tube, and primary peritoneal cancer referred 1 year before and after introducing the form. All patients were seen in a single fee-for-service university-based cancer center clinic.ResultsThere were 86 newly diagnosed ovarian cancer patients seen before and 83 seen after the introduction of the electronic referral form. Most lived in the metropolitan area and had stage III to IV disease, serous histology, a documented family history, and a treating oncologist who was less than 10 years from completion of fellowship. Postintervention referral rates increased from 17% to 30% (P = 0.053). Factors best predicting referral were whether the patient was seen after the intervention (P = 0.009), resided in the metropolitan area (P = 0.006), and had been identified as at high hereditary risk (P < 0.0001). Sixty percent of the referred patients participated in counseling. There were no differences in baseline characteristics of the referred patients before and after the intervention.ConclusionsReferral rates increased with the introduction of an electronic medical record referral form suggesting that streamlining the physician referral process might be effective at increasing referrals for cancer genetic risk assessment.

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Dissertations / Theses on the topic "Referral system"

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Aldarrak, K. A. "An evaluation of the Saudi referral system." Thesis, Swansea University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635741.

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This thesis started with the assumption that there are major defects in the Saudi referral system between GPs and specialists in hospitals. An ideal referral system was created from different resources in order to compare it with the Saudi one. In a latter stage of this research, it became apparent that these defects were only symptoms of the defects in the whole Saudi PHC system. Four different research methods were used to measure how close the ideal the Saudi referral system was, namely; questionnaires, interviewees, field observation and triangulation (city, town and village). The data gathered from GP, specialists and MOH officials indicated that the Saudi referral system is very far from ideal, (only 33.86%). There is a lot of work to be done in areas like communication between GPs and specialists, but more particularly with the nature of the PHC system including the availability of financial resources allocated to the system. Some of these problems have nothing to do with the MOH, but rather with the basic infrastructure in Saudi Arabia.

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Mo, Wentao. "A Referral-Based Recommender System for E-commerce." NCSU, 2001. http://www.lib.ncsu.edu/theses/available/etd-20010621-231234.

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<p>WENTAO MO. A Referral-Based Recommender System for E-Commerce (Under the direction of Dr. Munindar P. Singh).The thesis is intended to develop the technology and infrastructure to allow people to share knowledge with and learn from each other. A special kind of multiagent system, called multiagent referral system (MARS), is proposed. In MARS, each user is assigned a software agent, and software agents help automate the process of expertise location by a series of ?referral chains.? Unlike most previous approaches, our architecture is totally distributed and preserves the privacy and autonomy of their users. These agents learn models of each other in terms of expertise (ability to produce correct domain answers), and sociability (ability to produce accurate referrals). <P>

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Cruz, Melissa M. "A statewide comparative study of enhanced referral services given to teenage mothers offered by the Illinois child care resource and referral system through the teen parent initiative program and the non-enhanced referral services given to teenage mothers offered by the Illinois child care resource and referral system /." View online, 1996. http://repository.eiu.edu/theses/docs/32211131391450.pdf.

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Olupot-Olupot, Peter. "Evaluation of Antiretroviral Therapy Information System In Mbale Regional Referral Hospital, Uganda." Thesis, University of the Western Cape, 2008. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7320_1272589584.

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<p>HIV/AIDS is the largest and most serious global epidemic in the recent times. To date, the epidemic has affected approximately 40 million people (range 33 &ndash<br>46 million) of whom 67%, that is, an estimated 27 million people are in the Sub Saharan Africa. The Sub Saharan Africa is also reported to have the highest regional prevalence of 7.2% compared to an average of 2% in other regions. A medical cure for HIV/AIDS remains elusive but use of antiretroviral therapy (ART) has resulted in improvement of quality and quantity of life as evidenced by the reduction of mortality and morbidity associated with the infection, hence longer and good quality life for HIV/AIDS patients on ART.</p>

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Khunga, Helen. "Factors affecting detection and referral of malnourished children to Primary Health Care (PHC) level in Kanchele community of Kalomo District, Zambia." Thesis, University of the Western Cape, 2012. http://hdl.handle.net/11394/4508.

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Magister Public Health - MPH<br>Background: Malnutrition in children under the age of 5 years is a global public Health problem. The UNICEF report states that 10.9 million children under five die in developing countries each year due to malnutrition. According to the Zambia Demographic and Health Survey of 2008 malnutrition is one of the main childhood illnesses in Zambia with almost 50% of the under five children being stunted. The referral system in Zambia is organized in a way that starts at the Primary Health Care (PHC) level within the community and managed by the Community Health Workers (CHW). At this level, Community Health Workers screen and identify children that have childhood illnesses which require treatment and they refer them to the Rural Health Centre (RHC). When the problem cannot be handled at the RHC level the child is referred to the district hospital or provincial hospital level within a particular province. However, most children with malnutrition arrive late at the hospital for treatment. Some of them die soon after admission. It was not clear what prevent the mothers from bringing these children early to the hospital for treatment. Methods: The main aim of the study was to explore factors that are associated with detection and referral of malnourished children from Primary Health Care (PHC) at community level to the Health centres in Kalomo district. The study was conducted in Kanchele community of Kalomo in Southern Province of Zambia. Kanchele is a rural community with most basic services such as health facilities not being easily accessed. The study focused on two PHCs which had the highest prevalence of malnutrition. All participants were asked to sign a consent form after the purpose of study had been explained to them. They were informed that all information would be treated with confidentiality and that participation was voluntary and that they had the right to chose not to participate in the study. Furthermore each participant was asked if they agreed to maintain the confidentiality of the information discussed by participants and researchers during the focus group session. The study was qualitative in nature and focus group discussions were conducted with mothers or caregivers of children under five years, community members who have lived in the community for more than one year and community health workers who have also worked in the community for more than one year. Focus group discussions were used to collect data from mothers and community members. While in-depth interviews were used to collect data from CHWs and nutrition group leaders working at the PHC and community leaders. The data collected from the focus group discussions was analysed using thematic approach. Barriers or hindrances to rehabilitating a malnourished child mentioned by the respondents included lack of knowledge on malnutrition, failure to link malnutrition to poor feeding and bad health seeking habits, poor response to referral as a result of a system which is not supported with adequate resource such as transport, a system that does not support parents with food in-case of the child being hospitalised, the current hospital system only provides food to the patient. The failure by health staff to see that malnutrition is a key childhood disease. Data from this study will be used to develop interventions to improve the management of malnourished children. Conclusion: The study shows that mothers and community members are misinformed about the causes and treatment of malnutrition. It also clearly showed that traditional healers and grandparents played an important role in the diagnosis and treatment of malnourished children in this community. Interventions to improve identification and referral of these malnourished children needs to taken into consideration.

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Lim, Jung-Eun Jane. "THE EFFECTIVENESS OF THE MATERNAL REFERRAL SYSTEM IN DECREASING MATERNAL MORTALITY: A CROSS-CULTURAL ANALYSIS." Thesis, The University of Arizona, 2009. http://hdl.handle.net/10150/192533.

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Lemon, Stephen C. "Developing a school-based referral system: comparison of factors cited by school counselors and therapists." Thesis, Virginia Tech, 1987. http://hdl.handle.net/10919/45781.

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<p>When school-based behavior problems are not solvable in short-term school counseling, referrals are often made to community therapists. The school-based referral process is described in the literature as an informal process aimed at matching clientsâ needs with therapist skills but the literature also suggests that the referral process is based even more so on the relationship of the school counselor to the therapist. A survey of 19 school counselors was conducted to measure the importance of six factors identified in a pilot study that are used in selecting a referral source; Therapist Accessibility, Therapist Commitment to School, Therapist Philosophy and Belief System, Therapist Reputation, and Therapist Credentials. In addition, 19 community-based therapists were surveyed to measure their ranking of these same factors. When the scores were analyzed it was found that school counselors rated two scales, Therapist Accessibility and Therapist Reputation, significantly higher than did therapists. Surprisingly, Therapist Reputation was rated least important by both groups. This research has the potential to help strengthen the engagement between the school system and the mental health system by first identifying the factors used for school-based referrals and then identifying the differences in how the two systems perceive the importance of these factors.<br>Master of Science

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Campbell, Erica Basora. "The nurse's role in postpartum depression assessment, education and referral for women and their support system." Honors in the Major Thesis, University of Central Florida, 2010. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1376.

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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.<br>Bachelors<br>Nursing<br>Nursing

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Mwondela, Malala. "An exploration of the strengths and weaknesses of the referral and counter-referral system for maternal and neonatal health services between primary level health facilities and a tertiary hospital in Lusaka, Zambia." University of the Western Cape, 2017. http://hdl.handle.net/11394/5476.

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Master of Public Health - MPH<br>Introduction: Despite the progress that Zambia has made in reducing its maternal mortality ratio from 649 to 398 per 100,000 live births between 1996 and 2013/14, the country did not meet the Millennium Development Goal 5a target, of reducing the maternal mortality ratio by 75% (i.e. to a ratio of 162 per 100,000 live births) by the end of 2015. Thus, as is the case with many other countries, considerable challenges still remain in relation to reducing maternal mortality in Zambia. According to Zambia's Roadmap for Accelerating Reduction of Maternal, Newborn and Child Mortality (2013-2016), the continuum of care for reproductive and maternal, newborn, and child health includes integrated service delivery for mothers and children across these various time periods, and also across place: within the home, the community, and in health facilities. In this regard, a referral system plays a key role in linking the various levels at which care is provided, and the different types of services offered at these levels. In the urban district of Lusaka, Zambia, all complicated pregnancy-related cases received by health centres or clinics are referred to either Levy Mwanawasa General Hospital, or the University Teaching Hospital. However, it appears that at present those working at the primary level of care, who make such referrals up to these higher levels of care, receive no feedback on the outcome of their referrals; there are also few counter-referrals to the respective clinics in the district. With limited communication to the primary level of care, and with no formal handover of patients back to the clinics by the tertiary level institutions, it is difficult to ensure that the required continuum of care for the referred mothers and their children, post-delivery, has been established within the district. This explorative study aimed therefore to identify the strengths and weaknesses of the maternity-related referral system currently operating between primary and tertiary levels of health care in the district, and to consider how the system might be strengthened so as to support a stronger continuum of care with respect to maternal and neonatal health. Methods: Using a descriptive qualitative research approach, stakeholders involved in the planning, delivery and/or oversight of maternal and neonatal health services in the district were purposively sampled and asked to voluntarily participate in the study. Prior to all the interviews, after being informed about the study, and receiving information sheets to read through, participants were required to give informed consent. Their experiences and opinions regarding referrals and counter-referrals were collected through a series of 23 individual, semi-structured interviews. A Thematic Analysis approach was used to analyse data in this study. Ethics approval was first obtained from the Senate Research Committee, University of the Western Cape and thereafter from the Excellence in Research Ethics and Science Converge Ethical Review Board in Zambia, before proceeding with the study. Clearance was also obtained from the Ministry of Health, the Lusaka District Health Management Team and the University Teaching Hospital to facilitate entry into the health facilities. Findings: The study found that, in practice, the referral system for maternity and neonatal health does exist and is generally – but not optimally - functional in the Lusaka District. However, challenges were noted that included the fact that the district’s maternity referral system has not been revised since it was first developed in the 1980s and is not available in a comprehensive set of guidelines or standard operational procedures which explicitly outline the reasons for referral and the related referral steps and mechanisms. In addition, the referral forms currently in use in the district have not been standardised and appear to be inconsistently used by the different facilities. Interviewees reported that there were limitations in terms of the number of, and availability of ambulances, and that there was also an inadequate number of trained midwives. Limitations on the health service's infrastructure, namely, the physical space that is available, the number of delivery beds, and the limited supply of equipment place an additional burden on the staff working at both the primary and tertiary level. Conclusion: Overall, the study recommends that further research – possibly in the form of a baseline audit – be conducted so as to develop a more detailed and/or operational assessment of the actual rather than the reported level of functionality of the district's maternity referral system. Specific recommendations are also proposed for the various stakeholders who are critical role players in the referral system, namely, the clinics, the University Teaching Hospital, the Lusaka District Health Management Team, the Provincial Health Office, the Ministry of Health and Cooperating Partners.

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Isobell, Deborah Louise. "Referring agents’ perceptions of access barriers to inpatient substance abuse treatment centres in the Western Cape." University of the Western Cape, 2013. http://hdl.handle.net/11394/4060.

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Masters of Art<br>High rates of substance use and its associated problems afflict Cape Town, underscoring the need for easily accessible substance abuse treatment. Despite the substantial benefits for both individuals and society at large that substance abuse treatment confers, substance abusers often first have to negotiate considerable challenges in order to access treatment and accumulate these gains. That is, experiencing barriers to accessing treatment, together with the presence of socio-demographic features, rather than “need for treatment”, decides who accesses treatment. Referrals are the gateway to inpatient substance abuse treatment in the Western Cape. While several barriers to accessing treatment have been identified by prior studies, none examine these phenomena from the point of view of the agents responsible for referring substance users for treatment. Moreover, access barriers to inpatient substance abuse services are a neglected area in extant literature. To address this gap, this study explored the perceptions of referring agents‟ of the barriers to accessing state-funded inpatient substance abuse treatment centres in the Western Cape. This enabled the researcher to compare existing access barriers to treatment as identified by prior research, to those elucidated in the study. Bronfenbrenner‟s Process-Person-Context-Time model was employed as the basis for understanding identified barriers. In accordance with the exploratory qualitative methodological framework of the study, six semi-structured individual in-depth interviews were conducted with referring agents‟ of differing professional titles who were purposefully selected and expressed a willingness to participate in the study. Interviews were audio-recorded, and transcripts were analysed and interpreted by means of Thematic Analysis. Two broad thematic categories of access barriers were identified: Person-related barriers (denial, motivation for treatment, gender considerations, disability, active TB disease, homelessness, psychiatric co-morbidity) and Context-related barriers to treatment (cultural and linguistic barriers, stigma, community beliefs about addiction and treatment, awareness of substance abuse treatment, affordability/ financial barriers, geographic locations of treatment facilities, waiting time, lack of collaboration within the treatment system, beliefs of service providers‟, lack of facilities/ resources within the treatment system, practices at inpatient facilities, referral protocol and uninformed staff). Results suggest that by targeting the aforementioned barriers, access to inpatient and outpatient treatment services can be improved, and recommendations for interventions are offered in this regard. Ethical principles such as obtaining informed consent and ensuring confidentiality were abided by throughout the study and thereafter.

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Books on the topic "Referral system"

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Panel, FID/BSO. BSO referral test: Panel's report 1983. Published by FID/BSO Panel for Fédération Internationale de Documentation (FID) [and] United Nations Educational, Scientific and Cultural Organization (UNESCO), 1985.

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Gupta, Mona. A study of referral system for EmOC in Gujarat. Indian Institute of Management, 2009.

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Bourne, D. E. Database information and referral system for health and welfare resources. Human Sciences Research Council, 1997.

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Pahal, Satinderpal S. The object oriented analysis and design of a GP referral system. University of Manchester, Department of Computer Science, 1995.

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The muscle and bone palpation manual with trigger points, referral patterns, and stretching. Mosby/Elsevier, 2009.

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Sharkey, Joe. Bedlam: Greed, profiteering, and fraud in a mental health system gone crazy. St. Martin's Press, 1994.

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International Environmental Information System (United Nations Environment Programme). INFOTERRA: 15 years of making a difference. United Nations Environment Programme, 1992.

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Hoxley, Michael. Obtaining and retaining clients: A study of service quality and the client referral system of U.K. building surveyingpractices. University of Salford, 1993.

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Scales, Kate. Extending psychology into the referral process: An empirical investigation into the quality of a new adult mental healthreferral system. UEL, 1994.

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Women, Philippine Commission on. Guidelines in the establishment and management of a referral system on violence against women at the local government unit level. Philippine Commission on Women & Inter-Agency Council on Violence Against Women and Their Children, 2009.

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Book chapters on the topic "Referral system"

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Diaz, Javier, Laura Fava, Pablo Iuliano, Diego Vilches, Maria Alicia Terzaghi, and Jorge Rosso. "A Patient Referral and Counter-Referral Management System for Hospitals." In Communications in Computer and Information Science. Springer Berlin Heidelberg, 2011. http://dx.doi.org/10.1007/978-3-642-24352-3_20.

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Kaveeta, Vivatchai, Supaksiri Suwiwattana, Juggapong Natwichai, and Krit Khwanngern. "Requirements and Technical Design for Online Patient Referral System." In Advances in Internet, Data and Web Technologies. Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-70639-5_29.

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Donnelly, P. D., W. P. Ennis, and C. J. Roberts. "A PC-Based System to Audit Radiology Referral Practice, Costs and Exposure." In Medical Informatics Europe 1991. Springer Berlin Heidelberg, 1991. http://dx.doi.org/10.1007/978-3-642-93503-9_196.

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Grossmann, M., A. J. Lomax, and M. Goitein. "Network-wide application sharing as part of an electronic patient referral system." In The Use of Computers in Radiation Therapy. Springer Berlin Heidelberg, 2000. http://dx.doi.org/10.1007/978-3-642-59758-9_31.

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Collins, Sue, and George Goodson. "From ‘Personal Exercise on Prescription’ to ‘HELP’: Evolution of an Exercise on Referral System." In Sport and Physical Activity. Macmillan Education UK, 2007. http://dx.doi.org/10.1007/978-1-137-06127-0_13.

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Campbell, Corey, Douglas Smith, Kelly Lynn Clary, and Lori Egizio. "Screening, brief intervention, and referral to treatment (SBIRT) in the substance use system of care." In The Routledge Handbook of Social Work and Addictive Behaviors. Routledge, 2020. http://dx.doi.org/10.4324/9780429203121-23.

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Loureiro, Tibério C. J., Afonso B. L. Neto, Francisco A. A. Rocha, Francisca A. R. Aguiar, and Marcial P. Fernandez. "Multi-Agent System and Classification Algorithms Applied for eHealth in Order to Support the Referral of Post-operative Patients." In Advances in Intelligent Systems and Computing. Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-24097-4_2.

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KhudaBukhsh, Ashiqur R., and Jaime G. Carbonell. "Endorsement in Referral Networks." In Multi-Agent Systems. Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-14174-5_12.

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Herczog, Maria. "Poor Children, Poor Services, Poor Outcomes: Child Poverty and Its Impact on Referral and Placement in Public Care System in Hungary." In Children’s Well-Being: Indicators and Research. Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-17506-5_15.

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KhudaBukhsh, Ashiqur R., Jaime G. Carbonell, and Peter J. Jansen. "Proactive-DIEL in Evolving Referral Networks." In Multi-Agent Systems and Agreement Technologies. Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-59294-7_13.

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Conference papers on the topic "Referral system"

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Köster, Antonia, Christian Matt, and Thomas Hess. "Does the Source Matter? How Referral Channels and Personal Communication Tools Affect Consumers Referral Propensity." In Hawaii International Conference on System Sciences. Hawaii International Conference on System Sciences, 2017. http://dx.doi.org/10.24251/hicss.2017.473.

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Riati, Lisa, Ade Heryana, Cut Muda, and Erlina Mahadewi. "The Analysis of JKN-KIS Hospital Outpatient Referral System Implementation Subsequent to Online Referral Application." In 1st International Conference on Health. SCITEPRESS - Science and Technology Publications, 2019. http://dx.doi.org/10.5220/0009562500290033.

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Xiang-Wei Huang and Der-Ming Liou. "Implementation of an electronic emergency referral document system." In 2010 2nd International Conference on Education Technology and Computer (ICETC). IEEE, 2010. http://dx.doi.org/10.1109/icetc.2010.5529428.

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Reinhart, Ian, Khaled Dawoud, Omair Shafiq, Reda Alhajj, Jon Rokne, and Steven Edworthy. "Electronic medical referral system: A forum-based approach." In 2011 IEEE 13th International Conference on e-Health Networking, Applications and Services (Healthcom 2011). IEEE, 2011. http://dx.doi.org/10.1109/health.2011.6026740.

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Kidger, Vida, Catherine Gilsenan, Rhea Fielding, and Joanna Shakespeare. "Audit of an inpatient home oxygen referral system." In ERS International Congress 2016 abstracts. European Respiratory Society, 2016. http://dx.doi.org/10.1183/13993003.congress-2016.pa1397.

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Almansoori, Wadhah, Ayman Murshid, Konstantinos F. Xylogiannopoulos, Reda Alhajj, and Jon Rokne. "Electronic medical referral system: Decision support and recommendation approach." In 2012 IEEE 13th International Conference on Information Reuse & Integration (IRI). IEEE, 2012. http://dx.doi.org/10.1109/iri.2012.6303060.

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Le Xu, Li Li, V. Nagarajan, Dijiang Huang, and Wei-Tek Tsai. "Secure Web Referral Services for Mobile Cloud Computing." In 2013 IEEE 7th International Symposium on Service Oriented System Engineering (SOSE 2013). IEEE, 2013. http://dx.doi.org/10.1109/sose.2013.94.

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Hidayat, Tubagus Mochamad Teguh, and Suhono Harso Supangkat. "Mobile cloud design of referral for emergency medical service support system." In 2014 International Conference on ICT For Smart Society (ICISS). IEEE, 2014. http://dx.doi.org/10.1109/ictss.2014.7013177.

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Pushpa, S., K. S. Easwarakumar, Susan Elias, and Zakaria Maamar. "Referral based expertise search system in a time evolving social network." In the Third Annual ACM Bangalore Conference. ACM Press, 2010. http://dx.doi.org/10.1145/1754288.1754294.

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Wang, Xin, Qingxin Wu, Xu Liu, Yugang Jia, and Nathan Cohen. "Improvements on the Effectiveness and Scalibility of CMS Referral Analytics System." In 2016 IEEE International Conference on Healthcare Informatics (ICHI). IEEE, 2016. http://dx.doi.org/10.1109/ichi.2016.40.

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Reports on the topic "Referral system"

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DEPARTMENT OF THE ARMY WASHINGTON DC. Army Civilian Career Evaluation System (ACCES) Consolidated Career Program Referral Registration. Defense Technical Information Center, 2001. http://dx.doi.org/10.21236/ada402216.

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Angel M. Foster, DPhil, MD, AM, Angel M. Foster, DPhil, MD, AM. Evaluating women’s experiences with a referral system for safe and legal abortion care on the Thailand-Burma border. Experiment, 2016. http://dx.doi.org/10.18258/8659.

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McKenna, Patrick, and Mark Evans. Emergency Relief and complex service delivery: Towards better outcomes. Queensland University of Technology, 2021. http://dx.doi.org/10.5204/rep.eprints.211133.

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Emergency Relief (ER) is a Department of Social Services (DSS) funded program, delivered by 197 community organisations (ER Providers) across Australia, to assist people facing a financial crisis with financial/material aid and referrals to other support programs. ER has been playing this important role in Australian communities since 1979. Without ER, more people living in Australia who experience a financial crisis might face further harm such as crippling debt or homelessness. The Emergency Relief National Coordination Group (NCG) was established in April 2020 at the start of the COVID-19 pandemic to advise the Minister for Families and Social Services on the implementation of ER. To inform its advice to the Minister, the NCG partnered with the Institute for Governance at the University of Canberra to conduct research to understand the issues and challenges faced by ER Providers and Service Users in local contexts across Australia. The research involved a desktop review of the existing literature on ER service provision, a large survey which all Commonwealth ER Providers were invited to participate in (and 122 responses were received), interviews with a purposive sample of 18 ER Providers, and the development of a program logic and theory of change for the Commonwealth ER program to assess progress. The surveys and interviews focussed on ER Provider perceptions of the strengths, weaknesses, future challenges, and areas of improvement for current ER provision. The trend of increasing case complexity, the effectiveness of ER service delivery models in achieving outcomes for Service Users, and the significance of volunteering in the sector were investigated. Separately, an evaluation of the performance of the NCG was conducted and a summary of the evaluation is provided as an appendix to this report. Several themes emerged from the review of the existing literature such as service delivery shortcomings in dealing with case complexity, the effectiveness of case management, and repeat requests for service. Interviews with ER workers and Service Users found that an uplift in workforce capability was required to deal with increasing case complexity, leading to recommendations for more training and service standards. Several service evaluations found that ER delivered with case management led to high Service User satisfaction, played an integral role in transforming the lives of people with complex needs, and lowered repeat requests for service. A large longitudinal quantitative study revealed that more time spent with participants substantially decreased the number of repeat requests for service; and, given that repeat requests for service can be an indicator of entrenched poverty, not accessing further services is likely to suggest improvement. The interviews identified the main strengths of ER to be the rapid response and flexible use of funds to stabilise crisis situations and connect people to other supports through strong local networks. Service Users trusted the system because of these strengths, and ER was often an access point to holistic support. There were three main weaknesses identified. First, funding contracts were too short and did not cover the full costs of the program—in particular, case management for complex cases. Second, many Service Users were dependent on ER which was inconsistent with the definition and intent of the program. Third, there was inconsistency in the level of service received by Service Users in different geographic locations. These weaknesses can be improved upon with a joined-up approach featuring co-design and collaborative governance, leading to the successful commissioning of social services. The survey confirmed that volunteers were significant for ER, making up 92% of all workers and 51% of all hours worked in respondent ER programs. Of the 122 respondents, volunteers amounted to 554 full-time equivalents, a contribution valued at $39.4 million. In total there were 8,316 volunteers working in the 122 respondent ER programs. The sector can support and upskill these volunteers (and employees in addition) by developing scalable training solutions such as online training modules, updating ER service standards, and engaging in collaborative learning arrangements where large and small ER Providers share resources. More engagement with peak bodies such as Volunteering Australia might also assist the sector to improve the focus on volunteer engagement. Integrated services achieve better outcomes for complex ER cases—97% of survey respondents either agreed or strongly agreed this was the case. The research identified the dimensions of service integration most relevant to ER Providers to be case management, referrals, the breadth of services offered internally, co-location with interrelated service providers, an established network of support, workforce capability, and Service User engagement. Providers can individually focus on increasing the level of service integration for their ER program to improve their ability to deal with complex cases, which are clearly on the rise. At the system level, a more joined-up approach can also improve service integration across Australia. The key dimensions of this finding are discussed next in more detail. Case management is key for achieving Service User outcomes for complex cases—89% of survey respondents either agreed or strongly agreed this was the case. Interviewees most frequently said they would provide more case management if they could change their service model. Case management allows for more time spent with the Service User, follow up with referral partners, and a higher level of expertise in service delivery to support complex cases. Of course, it is a costly model and not currently funded for all Service Users through ER. Where case management is not available as part of ER, it might be available through a related service that is part of a network of support. Where possible, ER Providers should facilitate access to case management for Service Users who would benefit. At a system level, ER models with a greater component of case management could be implemented as test cases. Referral systems are also key for achieving Service User outcomes, which is reflected in the ER Program Logic presented on page 31. The survey and interview data show that referrals within an integrated service (internal) or in a service hub (co-located) are most effective. Where this is not possible, warm referrals within a trusted network of support are more effective than cold referrals leading to higher take-up and beneficial Service User outcomes. However, cold referrals are most common, pointing to a weakness in ER referral systems. This is because ER Providers do not operate or co-locate with interrelated services in many cases, nor do they have the case management capacity to provide warm referrals in many other cases. For mental illness support, which interviewees identified as one of the most difficult issues to deal with, ER Providers offer an integrated service only 23% of the time, warm referrals 34% of the time, and cold referrals 43% of the time. A focus on referral systems at the individual ER Provider level, and system level through a joined-up approach, might lead to better outcomes for Service Users. The program logic and theory of change for ER have been documented with input from the research findings and included in Section 4.3 on page 31. These show that ER helps people facing a financial crisis to meet their immediate needs, avoid further harm, and access a path to recovery. The research demonstrates that ER is fundamental to supporting vulnerable people in Australia and should therefore continue to be funded by government.

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Robert, J., and Michael Forte. Field evaluation of GNSS/GPS based RTK, RTN, and RTX correction systems. Engineer Research and Development Center (U.S.), 2021. http://dx.doi.org/10.21079/11681/41864.

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This Coastal and Hydraulic Engineering Technical Note (CHETN) details an evaluation of three Global Navigation Satellite System (GNSS)/Global Positioning System (GPS) real-time correction methods capable of providing centimeter-level positioning. Internet and satellite-delivered correction systems, Real Time Network (RTN) and Real Time eXtended (RTX), respectively, are compared to a traditional ground-based two-way radio transmission correction system, generally referred to as Local RTK, or simply RTK. Results from this study will provide prospective users background information on each of these positioning systems and comparisons of their respective accuracies during in field operations.

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Shrifter, Courtney. Child Welfare and Delinquency: Examining Differences in First-Time Referrals of Crossover Youth within the Juvenile Justice System. Portland State University Library, 2000. http://dx.doi.org/10.15760/etd.649.

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Baker, Justin S., George Van Houtven, Yongxia Cai, et al. A Hydro-Economic Methodology for the Food-Energy-Water Nexus: Valuation and Optimization of Water Resources. RTI Press, 2021. http://dx.doi.org/10.3768/rtipress.2021.mr.0044.2105.

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Growing global water stress caused by the combined effects of growing populations, increasing economic development, and climate change elevates the importance of managing and allocating water resources in ways that are economically efficient and that account for interdependencies between food production, energy generation, and water networks—often referred to as the “food-energy-water (FEW) nexus.” To support these objectives, this report outlines a replicable hydro-economic methodology for assessing the value of water resources in alternative uses across the FEW nexus–including for agriculture, energy production, and human consumption—and maximizing the benefits of these resources through optimization analysis. The report’s goal is to define the core elements of an integrated systems-based modeling approach that is generalizable, flexible, and geographically portable for a range of FEW nexus applications. The report includes a detailed conceptual framework for assessing the economic value of water across the FEW nexus and a modeling framework that explicitly represents the connections and feedbacks between hydrologic systems (e.g., river and stream networks) and economic systems (e.g., food and energy production). The modeling components are described with examples from existing studies and applications. The report concludes with a discussion of current limitations and potential extensions of the hydro-economic methodology.

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Kennedy, Alan, Jonathon Brame, Taylor Rycroft, et al. A definition and categorization system for advanced materials : the foundation for risk-informed environmental health and safety testing. Engineer Research and Development Center (U.S.), 2021. http://dx.doi.org/10.21079/11681/41803.

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Novel materials with unique or enhanced properties relative to conventional materials are being developed at an increasing rate. These materials are often referred to as advanced materials (AdMs) and they enable technological innovations that can benefit society. Despite their benefits, however, the unique characteristics of many AdMs, including many nanomaterials, are poorly understood and may pose environmental safety and occupational health (ESOH) risks that are not readily determined by traditional risk assessment methods. To assess these risks while keeping up with the pace of development, technology developers and risk assessors frequently employ risk-screening methods that depend on a clear definition for the materials that are to be assessed (e.g., engineered nanomaterial) as well as a method for binning materials into categories for ESOH risk prioritization. In this study, we aim to establish a practitioner-driven definition for AdMs and a practitioner-validated framework for categorizing AdMs into conceptual groupings based on material characteristics. The definition and categorization framework established here serve as a first step in determining if and when there is a need for specific ESOH and regulatory screening for an AdM as well as the type and extent of risk-related information that should be collected or generated for AdMs and AdM-enabled technologies.

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Harter, Rachel M., Joseph P. McMichael, Derick S. Brown, Ashley Amaya, Trent D. Buskirk, and David Malarek. Telephone Appends for Address-Based Samples— An Introduction. RTI Press, 2018. http://dx.doi.org/10.3768/rtipress.2018.op.0050.1802.

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Surveys with samples selected from an address frame derived from US Postal Service sources are often referred to as address-based sampling (ABS) surveys. For an ABS survey that is primarily conducted by mail, web, or face-to-face, sometimes it is helpful to have a telephone number corresponding to the sample addresses for setting appointments or conducting nonresponse follow-up prompts. The usefulness of a telephone contact mode in a mixed mode ABS design depends on both the percentage of addresses for which telephone numbers can be appended (append rate or match rate) and the accuracy of the telephone numbers associated with addresses. Before planning a telephone contact as part of a mixed-mode study, the designer should know the likely effectiveness of the approach. This paper focuses primarily on append rate information, with a discussion of accuracy rates. For a single ABS frame, telephone match rates vary by geography, address type, match vendor, and by landline vs. cell telephone number. Using very large samples of addresses from a total US ABS frame, we estimated state and national telephone append rates from Marketing Systems Group's sources. The append rates are summarized here and interactively at the website http://abs.rti.org/atlas/.

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Job, Jacob. Mesa Verde National Park: Acoustic monitoring report. National Park Service, 2021. http://dx.doi.org/10.36967/nrr-2286703.

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In 2015, the Natural Sounds and Night Skies Division (NSNSD) received a request to collect baseline acoustical data at Mesa Verde National Park (MEVE). Between July and August 2015, as well as February and March 2016, three acoustical monitoring systems were deployed throughout the park, however one site (MEVE002) stopped recording after a couple days during the summer due to wildlife interference. The goal of the study was to establish a baseline soundscape inventory of backcountry and frontcountry sites within the park. This inventory will be used to establish indicators and thresholds of soundscape quality that will support the park and NSNSD in developing a comprehensive approach to protecting the acoustic environment through soundscape management planning. Additionally, results of this study will help the park identify major sources of noise within the park, as well as provide a baseline understanding of the acoustical environment as a whole for use in potential future comparative studies. In this deployment, sound pressure level (SPL) was measured continuously every second by a calibrated sound level meter. Other equipment included an anemometer to collect wind speed and a digital audio recorder collecting continuous recordings to document sound sources. In this document, “sound pressure level” refers to broadband (12.5 Hz–20 kHz), A-weighted, 1-second time averaged sound level (LAeq, 1s), and hereafter referred to as “sound level.” Sound levels are measured on a logarithmic scale relative to the reference sound pressure for atmospheric sources, 20 μPa. The logarithmic scale is a useful way to express the wide range of sound pressures perceived by the human ear. Sound levels are reported in decibels (dB). A-weighting is applied to sound levels in order to account for the response of the human ear (Harris, 1998). To approximate human hearing sensitivity, A-weighting discounts sounds below 1 kHz and above 6 kHz. Trained technicians calculated time audible metrics after monitoring was complete. See Methods section for protocol details, equipment specifications, and metric calculations. Median existing (LA50) and natural ambient (LAnat) metrics are also reported for daytime (7:00–19:00) and nighttime (19:00–7:00). Prominent noise sources at the two backcountry sites (MEVE001 and MEVE002) included vehicles and aircraft, while building and vehicle predominated at the frontcountry site (MEVE003). Table 1 displays time audible values for each of these noise sources during the monitoring period, as well as ambient sound levels. In determining the current conditions of an acoustical environment, it is informative to examine how often sound levels exceed certain values. Table 2 reports the percent of time that measured levels at the three monitoring locations were above four key values.

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