Communication to support patient referral and multidisciplinary collaboration

Australia’s health system is complex and the delivery of health care involves a large network of services and providers, across multiple settings. This can include healthcare providers in primary and community healthcare settings, specialist services, acute emergency services and hospital-based services, as well as rehabilitation and palliative care.

It is common for a person to access multiple healthcare services and healthcare providers; and to be referred or transferred between these different providers and services. At transitions of care, situations when all or part of a person’s care is transferred between healthcare locations or providers, and as the patient’s conditions and care needs change, the risk of communication errors is increased. 

Communication errors and ineffective communication between healthcare providers, multidisciplinary teams and with the patient and their family or carer can lead to poorer health outcomes, patient distress and inappropriate care. Therefore, the healthcare service should support its healthcare providers to refer to and collaborate with other care providers by: 

• Using best-practice structured communication processes
• Considering the patient’s risks, goals and preferences for health care when communicating with, and in referrals to, other providers and services 
• Communicating information that is current, comprehensive and accurate
• Including the patient, their carer and family in communication processes.

Healthcare providers must be supported to: 

• Know the healthcare service’s processes, tools and forms for communicating at transitions of care
• Know who to communicate with and when they need to communicate for any transition of care
• Identify what minimum information is required to be communicated for any particular transition
• Have the skills to undertake structured communication
• Have the skills to communicate effectively with patients, families and carers, including agreeing what information they consent to be shared with other healthcare providers. 

• What resources or processes does your healthcare service have to support communication and collaboration with other care providers when a patient is being referred?
• How is your workforce supported to develop and maintain skills for effective communication?

The type and comprehensiveness of evidence used is dependent on each healthcare service context. The content and complexity of the policies and processes will likely depend on the size of the healthcare service, but could include:

• Documents outlining the process for communicating emerging or changing critical information 
• Templates to support clinical communication, such as referral forms, standardised comprehensive care plans, medication lists or checklists for referrals
• Templates or tools that support healthcare providers to partner with the patient to communicate critical information, risks and goals or preferences 
• Examples of referrals or communication between healthcare providers and the patient
• Demonstration of shared leadership and collaborative teamwork in multidisciplinary healthcare teams in rural and remote settings.

Commission resource

• Communicating for safety resource portal – provides practical support for the implementation of the communicating for safety actions in the NSQHS Standards. The principles and strategies outlined in these resources are broadly applicable.