The demand for outpatient services at Bendigo Health far outstrips supply at present. For this reason almost all cases should be referred back to the GP in the first instance. The GP's generally will be able to decide whether to manage it themselves, refer to outpatients at Bendigo, refer to the private rooms of the appropriate specialist or refer to another outpatients department at a better resourced health service nearby or in Melbourne. Bendigo patients are not unfamiliar with going to Melbourne for some specialist services.
All private patients should be referred to private rooms if not to the GP.
Fracture Clinic runs once a week on a Monday afternoon. It is only for patients with fractures. Buckle fractures and other very minor fractures which are not going to need further active management apart from removal of a brace or cast should not be referred to fracture clinic. They can be followed up by the GP and if removal of a plaster is not possible in general practice they can come back to ED at 0800hrs on a weekday to have the POP removed. If there is any doubt about the timing of a visit to fracture clinic consult the on-call orthopedic registrar and record their name on the referral form. If a fracture is unstable (the majority that are referred to Fracture clinc should fall into this category) a repeat Xray in plaster is appropriate and a form should be given to the patient specifying this and a note on the discharge summary should indicate that you have ordered one. If a fracture is suspected but not proven (e.g. Scaphoid fractures) then a repeat Xray out of plaster is required. Once again, the requrest should indicate that the Xray is to be taken out of plaster. These patients should only have a removable slab applied which can be easily removed at Xray.
ENT Clinic is booked up years in advance. The only reason to refer someone to ENT clinic is if the ENT surgeon asks to see them on a specific date. Record the name of the surgeon and the date of the required clinic on the referral form.
Urology Clinic is booked up years in advance. Speak to the urologist directly about anyone needing outpatient urology consultation so they can decide whether to squeeze them in to a clinic or admit them.
Registrar Review Clinics are run by some units for follow up of their inpatients. Some registrars may request to see patients in those clinics that they have seen in the ED. This is at their discretion.
When referring to outpatients use the section at the bottom of the ED discharge summary form. You must write who you spoke to, who requested the clinic and its justification otherwise it will be rejected by the outpatient triage process.