How to Refer a Patient

TIA Service

Regular Information

An enhanced Daily, Weekday, ‘One-Stop’ RASP service for patients in our catchment area with suspected TIAs has been operational from May 3rd 2010 at Tallaght Hospital under the co-direction of Dr. Dominick McCabe and Dr. Ronán Collins, in collaboration with our RASP service colleagues.

Dr McCabe’s Neurology team runs the clinic service one week, and Dr. Collins/Prof O’Neill/Dr. Coughlan and the Age Related Health Care/Stroke Service team will run the service the following week.

It is essential that only suspected TIA patients are referred to this Rapid-Access service that is being run without any additional manpower or resources.

All TIA patients with ‘high risk’ clinical features should be referred for urgent admission with the revised AMNCH web-based RASP referral proforma regardless of their ABCD2 Score, as should all suspected TIA patients with an ABCD2 Score of ≥ 4 (see attached revised proforma).

‘Lower risk TIA patients’ who do not fulfil any of the high risk admission criteria, and who have an ABCD2 Score of 0-3, should be referred by faxing the revised AMNCH web-based RASP referral proforma to the Stroke Service Nurse Specialist each day from Monday 9am to Friday am (01 4143244). We aim to allocate an appointment within 24 hours to urgently assess these patients.

‘Lower risk’ TIA patients in the catchment area seen by their GP, or the Emergency Department (ED) staff at the weekend from Friday pm to Monday 9am, who have an ABCD2 Score of 0-3, will need to be referred to the ED for assessment and possible admission under the medical team on call if a TIA is confirmed (a low threshold for referral to the medical team is recommended). The medical team staff will subsequently refer patients to the RASP/Stroke Service, as appropriate, on Monday am.

Following assessment by the RASP service, an urgent decision re management and secondary prevention therapy, including anti-thrombotic therapy, will be made and communicated to the referring doctor, in turn. The service will be prospectively audited to assess the accuracy of diagnosis and risk stratification of suspected TIA patients by the referring physicians to plan future service delivery.

TIAs are medical emergencies that warrant urgent assessment

1. Refer the following ‘high risk’ patients to ED for urgent admission with the revised Tallaght Hospital web-based RASP referral proforma:

  • TIA patients with ‘high risk’ clinical features, regardless of the ABCD2 Score
  • TIA patients with an ABCD2 Score of ≥ 4


2. Refer the following ‘lower risk’ TIA patients for urgent outpatient assessment by the RASP service, if seen between Monday 9am – Friday am:

  • TIA patients’ who do not fulfil any high risk admission criteria, and have an ABCD2 score of 0-3


3. All TIA patients seen by the ED staff or by their GP at the weekend from Friday pm to Monday am, regardless of the ABCD2 score, should be referred for assessment and possible medical admission if a TIA is confirmed.

If admitted over the weekend, the Medical Team on-call should refer to the RASP team on duty on the Monday, as appropriate.

Following assessment of any of the above categories of TIA patient referrals by the RASP service staff, an urgent decision re management and secondary prevention therapy, including anti-thrombotic therapy, will be made and communicated to the referring doctor, in turn.


Electronic Orthopaedic Referrals

Orthopaedics

The National Centre for the Treatment of Pelvic and Acetabular Fractures Tallaght Hospital

The following instructions relate to tertiary Pelvic & Acetabular fractures only. This email referral process must be used. Hand Written letters will not be accepted.

 **Updated February 2016

To refer a patient:

  1. Copy and paste the referral template information in to an email and send to orthopelvis@amnch.ie.
  2. Radiology images can be sent via NIMIS. Alternatively;
  3. Attach Radiograph Images: maximum of five radiograph images, including Pelvic Fractures: AP Pelvis, In-let, Out-let views, Acetabular Fractures: AP Pelvis, Judet Views (Internal Oblique, Obturator Oblique)
  4. Attach Radiology Images: We do not require the entire CT Pelvis to be transmitted electronically, if relevant: please select a maximum of 12 small sized cuts with four per image/page (a CD should be sent with the patient with ALL relevant radiographs on transfer)
  5. The total size of all attachments must be less than 10MB. It may be possible to attach PACS images which are less than 10MB but for ease of viewing via internet explorer within the hospital, a JPG file representation would be preferred. 

Click here for Template

 After referral:

  1. An automated acknowledgement of your referral will be sent.
  2. The National Co-ordinator for the service will liaise with the Pelvic & Acetabular team in Tallaght Hospital to establish whether the patient can be accepted.
  3. The National Co-ordinator will contact the referring hospital to confirm acceptance. If accepted admission dates will be agreed.
  4. Following admission and surgery, the National Co-ordinator will contact the referring hospital in relation to returning the patient. The referring hospital has an obligation to accept the patient back once the surgery has been completed and the team in Tallaght Hospital are satisfied that patient can be transferred.

 

National Co-ordinator Contact Details

Ms Pauline Harrison, tel: +353-(0)1 414 2348 or call hospital switch +353-(0)1 414 2000 bleep 1155

Data Protection:

It is the sender’s responsibility to ensure the email is encrypted before being transmitted over the public Internet. It should be noted that personal webmail accounts such as Google, Yahoo, Hotmail and Live mail do not encrypt email. It is understood that non encrypted email containing patient data breaches data protection law.

If the sender has any doubt in this regard he/she should refer to their own ICT department. The hospital’s email system is encryption enabled. Organisations which exchange email with AMNCH can do so by “SMTP over TLS” encryption. This means that the sending organisation’s email server communicates with the Tallaght Hospital email system provided it supports “SMTP over TLS”.

Referral Forms

In order to facilitate the referral process for GPs we have streamlined many of our referral forms. GPs can now download the relevant form when required and be confident that they are providing sufficient information to ensure the referral can be processed in a timely manner.

SpecialtiesDocuments

Spinal Referral

The spinal referral can be used for the following specialties involved in spinal management (Orthopaedics, Rheumatology, Pain Management and the Back Pain Screening Clinic). Click here to access the form.

TIA

Rapid Access Stroke Prevention (RASP) Service

An enhanced, ‘one stop’ RASP service, operates Monday to Friday for suspected TIAs.

Click here for full details and instruction on how to use this service.

Click here to download the referral form.

Click here for a patient information leaflet.

Rheumatology Clinic

Patients need a letter from their General Practitioner (G.P.) or referring doctor/health professional. The referral form has been endorsed by the ISR and ICGP and can be automatically generated directly from Helix Healthcare and Socrates GP practice software. If you do not use these software packages please click here and forward it to us together with a referral letter. This referral form is for Patients with Early Inflammatory Arthritis. 

The letter should be sent to: Rheumatology Secretary, Dept of Rheumatology, Tallaght Hospital, Tallaght, Dublin 24. 

Psychology

For patients that are living with chronic health conditions Tallaght Hospital has developed a joint initiative with the local community facilitated via the Fettercairn Community Health Project.  The Living Well programme is a six week course is designed to help those living with a chronic disease, which can present extreme difficulties and affect multiple aspects of individual’s life such as physical health, mental health and financial status. If you have a patient that you believe would benefit from this programme please complete this referral form.

eReferrals
Tallaght Hospital accepts healthlink referrals to all Paediatric specialties since 2013. The Pigmented Lesion Clinic for Dermatology as part of the National Cancer Programme opened in 2015.

Adult eReferrals is currently being rolled out in the hospital and all specialties will be ‘live’ by mid-September. Access to eReferrals in Tallaght Hospital is operated by the Healthlink Group and they can be contacted on 01 882 5606