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Govt calls for audit of referrals from district hospitals

The Health and Medical Education Department of the Government will audit all referrals from district level hospitals to tertiary care hospitals in order to optimize the manpower available in peripheries and patient services across the healthcare system, as per a fresh order.

Kashmir’s tertiary care hospitals have often complained about their facilities and services being overburdened due to the load of patients. At SMHS Hospital for example, over 1500 OPD tickets are issued in a day.

The Children Hospital, the Lal Ded Maternity Hospital and other hospitals have been citing ‘unnecessary referrals’ as a main reason for over-stretching of the facilities.

A senior health official said that for many years, J&K Government has been stressing to make referrals accountable and recommended only on the assessment of patient condition and treatment requirement.

In this direction, an order was issued earlier this week calling for a referral audit of Health Institutions of J&K seeking a monthly report of referrals from Directorates of Health Jammu and Kashmir and from the Government Medical Colleges of Srinagar and Jammu.

“The Principal Secretary to Government Health and Medical Education has taken a strong note of the referrals of the patients from District Health Institutions to the Tertiary Care Institutions,” reads the order.

It adds that the practice (of unnecessary referrals needs to be curbed as it results in the huge load to the tertiary care institutions besides under-utilization of district level manpower and facilities.

The referral audit of every month, as per the order, will be carried out on the third day of every subsequent month by the Health and Medical Education Department (H&ME). “Accordingly, I am directed to request you to kindly forward a monthly audit report of all the referrals received or sent by your respective institutions to the administrative department H&ME”. The format for referral audit exists already reads the document issued by Officer on Special Duty, H&ME.

However, such moves by the Government have a history of fizzling out. In January 2019, J&K government publicised a Standard Operating Protocol (SoP) for instituting answerability in healthcare institutes in case of referrals. ‘Referral Audit Committees’ were announced for monitoring patients sent from one hospital to the other and take action on cases where the protocols had not been followed.

As per the SoP, prepared by GMC Srinagar, a doctor who decides to send a patient to a higher institute had to ensure that the patient reaches the hospital safely.

For this, the doctor had to follow an inventory before deciding that a case could not be handled at the level wherefrom the referral was taking place. In addition, the referrals as well as the investigation were mandated to have the name, registration number, seal and signature of the doctor on duty.

None of it took off, many blaming it on the Pandemic and many other doctors on the lack of follow-up by the Government. Greater Kashmir

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