{"id":110,"date":"2008-04-05T08:35:36","date_gmt":"2008-04-05T13:35:36","guid":{"rendered":"http:\/\/72.9.147.40\/archives\/2008\/04\/serial-referral-delays-are-harm.html"},"modified":"2008-04-05T08:35:36","modified_gmt":"2008-04-05T13:35:36","slug":"serial-referral-delays-are-harm","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2008\/04\/serial-referral-delays-are-harm.html","title":{"rendered":"Serial referral delays are harm"},"content":{"rendered":"

I want to introduce a term: “serial referral delays.”<\/p>\n

I assert that serial referral delays are harm, and they’re a metric we can track at any level from individual hospital to the entire nation or planet. First, a little discussion, then “how can we start?”:<\/p>\n


\nAt Boston’s Beth Israel Deaconess, Paul Levy<\/a> is working diligently on instituting process changes that are already proven in industry to minimize errors and improve efficiency. This morning<\/a> he notes that in the UK, surgeon Ara Darzi<\/a> has responsibility for reforming their health system, where costs have tripled in 11 years. (Chase the links there.)<\/p>\n

Perhaps because Lord Darzi has no government experience, he’s starting from the most fundamental questions, such as “Is the job getting done at all?”<\/p>\n

\u201cIt is all obvious stuff, but we have never done it this way,\u201d admits Darzi. He says that the problem is that \u201cif you look at a journey of a patient, it’s fragmented. How do you integrate that care?\u201d He cites the example of a patient with kidney pain who is referred by a GP to a consultant and then sent for an X-ray on a different day, then back to the consultant for an initial assessment. \u201cIf you are shopping in Tesco you wouldn’t do that. You need to have access to competency at the time you need it.\u201d<\/p><\/blockquote>\n

Hooray for that!<\/p>\n

I rarely hear senior management talking about the anxiety caused by these delays, but patients sure do. And that’s not to mention the actual harm that can be caused by a condition progressing while waiting for care: harm.<\/p>\n

Managers like Paul are at work on reducing the delays, but there are a lot of mountains to be moved. Meanwhile, you and I are hung out to dry, unable to get care until the system gets around to it.<\/p>\n

Here’s the thing: serial referral delays are a fundamental problem that arises in the model where healthcare is only accomplished by institutions whose time is scarce<\/u>. In the participatory model<\/strong>, patients don’t wait. Engaged with their peer communities, they can discuss symptoms, organize support, take steps, and even go somewhere else when they know they need something that their current provider can’t deliver.<\/p>\n

You can tell empowered, participatory patients because we don’t sit around being victims, we do something about it. <\/p>\n