Why hospital referral guidelines are necessary

July 23, 2014 12:41 pm
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And in more dire consequences, an inefficient referral system could lead to the loss of life, "when the patient gets lost in the system," USAID HIV/AIDS Team Leader for Kenya, René Berger said/XINHUA-File
And in more dire consequences, an inefficient referral system could lead to the loss of life, “when the patient gets lost in the system,” USAID HIV/AIDS Team Leader for Kenya, René Berger said/XINHUA-File
NAIROBI, Kenya, July 23 – A skit formed a part of the entertainment. A form of entertainment, as skits are, meant to impart a dose of knowledge in a capsule of humour.

This one revolved around a couple living in Kathiani constituency of Machakos County. The husband – clad in stereotypical luminous green socks pulled over his trousers – complained of a putrid smell that emanated from his wife. “I’ve taken her to every witchdoctor I know, even one from Tanzania,” he joked to an acquaintance.

An acquaintance who referred him to his primary healthcare provider and from whence they were referred to the Kenyatta National Hospital; the point of the skit to demonstrate how referrals in the public health sector, should operate.

It was after all, the launch of the 2014-17 referral strategy and guidelines by the Ministry of Health (MOH). A strategy, Health Principal Secretary Fred Segor said, aimed at guaranteeing quality health care for all.

“The concentration of specialists in Nairobi is very, very high and this denies those who are living very far from Nairobi, services,” he said.

A state of affairs that created a strain on referral hospitals, PIMA Project Director Edward Kunyanga explained. “If you go to KNH you’ll find a queue of people who’ve referred themselves there whereas their problems could have been addressed at the primary level.”

And in more dire consequences, an inefficient referral system could lead to the loss of life, “when the patient gets lost in the system,” USAID HIV/AIDS Team Leader for Kenya, René Berger said.

Therefore the MoH with support from USAID, PIMA and the World Health Organisation developed the 2014-17 referral guidelines and on Wednesday launched into a county collaborative process given the devolution of health services.

The aim of the strategy, “as brought out in the skit,” Kunyanga said, is to reduce the costs associated with referrals. “Remember the concern the couple had over fare to Nairobi.”

Costs the MoH hopes to address in its strategy by categorising the form referrals could take into three: client, expertise, specimen.

Client being the option of choice in emergency situations where the required expertise and equipment is not available at the community or primary health care level.

Expert movement being the preferred option in non-emergent situations while specimen movement being the preferred option where blood, for example, can be drawn and taken for testing.

All of which, Segor said, can be bolstered by Information Communication Technology: “Through e-health, the experts will not always have to move, they can attend to the patient’s remotely and where a second opinion is sought, the patient’s records can be accessed online, as would be the results of specimens tested.”

All long term cost cutting measures, Segor said – coming back full circle – aimed at providing quality health care, to all.

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