Criteria for cases to be passed to Consult and Hold (C&H) - Follow Up Queue
For senior clinical review/ follow up of case if
- Patient line criteria not met
- and clinical risk/ concern warrants pro-active follow up by a senior clinician
- and the original consulting clinicians is not able to undertake the follow up themselves
Examples include:
- Urgent lab investigations arranged by the service, where results will determine the IUC management of the patient. A clear plan should be documented in the notes.
- Visit to unwell patient, the visiting clinician advises admission but the patient refuses.
- Patient has dementia and lives alone, follow up is required but the patient may not be able to use the patient line appropriately.
- If agreed in direct discussion between the Clinical Coordinator (CC) and a remote working clinician that prescriptions requiring printing can be forwarded to the C&H queue for the CC to action (should not be required once EPS is live)
Cases passed to the C&H queue must have had clinical input, with the clinical review and plan documented in the Adastra notes. The first line of the notes/ comfort call note should log the action required at what time/ day. It is therefore a clinical, not operational, decision to pass cases to the C&H queue.
- If a case is complex, then there should be a clinician to clinician discussion to handover the case to support continuity and patient care eg complex mental health case
To forward a case to the Consult and Hold Follow Up queue, selecting the follow up box and follow end assessment process. Most cases requiring follow up should be managed in the IUC advice queue, not the C&H Follow Up queue.
Most cases requiring follow up should be managed in the IUC advice queue, not the C&H queue.
- Failed contacts should be managed as per the SOP. If there have been three failed contacts, a clinician needs to review the case to determine the next steps. The clinical review of the case and plan should be documented. If the case cannot be closed at this point, further clinician attempts to contact the patient should be made. If senior clinician input is needed, the case should be moved to the Consult and Hold Follow Up If senior clinician input is not required the case should remain in the IUC Advice CAS queue. The top line of the notes/ comfort call should include the time/ day/ date/ action required.
- Cases for clinical review within 4 hours or less, but not requiring senior clinical input. This follow-up is best done by the original consulting clinician, and can be actioned by finishing the consultation and selecting Save & return to queue but if this is not possible (eg at the end of a shift) the case should be discussed and handed over by the first clinician to the subsequent clinician. The top line of the notes/ comfort call note should log the time of the follow up and the name of who will do the follow up.