Committee on Utilization, Review, and Education common referral form

Creating the form

With the objective of improving the referral process, CURE began creating a common referral form (CRF) in 2010 and 2011. Three members of the committee (R.L., C.G., and I.N.) identified all the referral forms used in their own practices. The total number of forms was greater than 55, excluding diagnostic imaging, for which there were more than 2 dozen different forms. These forms were reviewed to identify common core information requested by most specialists. The committee members combined this core information into one form. They also reviewed the common referral template from the College of Family Physicians of Canada. Some of the information fields on the College form are identical to those on the CURE form, but our family doctors found the College form less succinct and hence less likely to be completed.

After several revisions, a draft CRF was sent to all specialists in Hamilton region for comment. Feedback was largely positive, with some suggestions to include more information (eg, about the patient’s language and mobility) and to change “urgent appointment” to “see within 2 weeks,” because no urgent referrals were accepted.

The draft CRF was revised to include appropriate suggestions. The revised draft could be used as is by practices using paper charts or as a template by practices using electronic medical records. This revised draft was circulated to all the members of the Department of Family Medicine at St Joseph’s Healthcare to ensure that family doctors found the form usable and practical. The final CRF was made available to family physicians in the Hamilton area in January 2012. The CRF is available at CFPlus.*

The Nephrology Division at St Joseph’s Healthcare was the first to officially recognize the CRF and asked its catchment of family physicians to begin using the form in July 2012. Other chiefs of departments on the Medical Advisory Committee at St Joseph’s Healthcare gave their official support for the use of the CRF in December 2012.

Using the CRF

In our experience, the support of the Medical Advisory Committee increased the use of the CRF. However, a few specialty clinics still require that their own forms be completed. Exact reasons for this are unknown. We postulate that some specialists and clinics might need very specific information that is not part of the CRF core information. Our hope is that these clinics accept the CRF and then request extra information if it has not been provided. Additionally, staff and physicians might be trained to look for specific information in certain areas on their own referral forms, so using their own forms saves them time.