From the NSW perspective the more common interstate referral pathways for people requiring brain injury specialist rehabilitation are:
- ACT – NSW
- Queensland – NSW
- South Australia – NSW
- Victoria – NSW.
The principles to apply to these referrals include the following.47
- Referrals are made to settings that have the level of care required by the client at the point of referral.
- The client should be admitted directly to an inpatient bed and relevant service and not via inappropriate pathways, for example the emergency department unless deterioration in the patient’s condition requires assessment in the emergency department.
- Good communication and clinical handover between referring and receiving senior clinicians that involves the patient flow units, resulting in the coordination of timely and safe patient transfer for ongoing care within medically agreed timeframes.
- Timely escalation involves immediate escalation with the appropriate service managers for decision making when an issue regarding patient transfer arises which will impact on the patient accessing safe and timely care within the medically agreed timeframe.
- Patient flow responsibility means that all facilities have personnel tasked with coordinating patient flow.
Memorandum of understanding
Ideally a memorandum of understanding and agreed policy documents on how these principles are to be implemented for each interstate referral pathway.
For paediatric rehabilitation services linked with one of the three tertiary children’s hospitals the referral process both ways is a medical referral to the respective paediatric rehabilitation service in the relevant state (Victoria = VPRS; Queensland = QPRS).