Referral Processing Overview
Applies to: Version 6.23 and later
Last updated: 28 February 2023
Overview
This document provides an overview of the process for inbound referrals. A referral is a request for a whānau or individual to access a service that is managed in Whānau Tahi Navigator. It can also be treated as an invitation for an assigned kaimahi, case worker, or clinician to gain access to the relevant whānau plan.
There are two main variations on the stages a referral goes through. These are outlined below.
Standard Referral
- Entered. The referral is entered into the system. This could be done by a receptionist, communications team member, kaimahi/case worker, kaihono, etc. After entering the required details (including the service) verifying accuracy, and attaching appropriate documents, they user presses Send to move the referral to the next stage.
- Recieved. The referral is ready for review by the team leader for the identified service. They allocate the resonsible kaimahi, and Accept the referral. This status is skipped if the Allow one Click Send Accept has been configured for the service identified on the referral.
- Accepted. The referral has been accepted. At this stage, the assigned kaimahi may record efforts to connect with whānau or individual on the referral. If the service on the referral was configured with enrollment activities, these should be completed here. If any of those activities as flagged as requried, then they must be completed here before you can progress to the next stage. When any required enrollment activities have been completed, the users presses Enroll.
- Active. The referral is an open (active) referral. All work on this referral should be recorded on the associated whānau plan.
- Closed. The whānau or individual on this referral have been discharged (using an exit activity on the plan), and this referral is now closed.
Triaged Referral
Referrals can optionally have a triage stage. When triage is enabled, referrals can be entered without specifying a requested service. The referrals are then reviewed by a triage individual or team, who determines and adds the appropriate service(s) to the referral, before sending it to the service leaders for action.
Triage is enabled or disabled system wide. To enable triage, the system admin sets the Enable Triage setting in System Configuration to TRUE.
- Entered. The referral is entered into the system. This could be done by a receptionist, communications team member, kaimahi/case worker, kaihono, etc. After entering the required details (including the service) verifying accuracy, and attaching appropriate documents, they user presses Submit to move the referral tot he next stage.
- Triage. The referral is ready for review by a triage, MDT, Rōpū, or other team or individual responsible for an initial call on requiremnts. After review, they set the service for this referral, and Send it.
- Recieved. The referral is ready for review by the team leader for the identified service. They allocate the resonsible kaimahi, and Accept the referral.
- Accepted. The referral has been accepted. At this stage, the assigned kaimahi may record efforts to connect with whānau or individual on the referral. If the service on the referral was configured with enrollment activities, these should be completed here. If any of those activities as flagged as requried, then they must be completed here before you can progress to the next stage. When any required enrollment activities have been completed, the users presses Enroll.
- Active. The referral is an open (active) referral. All work on this referral should be recorded on the associated whānau plan.
- Closed. The whānau or individual on this referral have been discharged (using an exit activity on the plan), and this referral is now closed.
Combine Send and Accept stages for Standard Referrals
If you are using the Standard Referral pathway (triage is not enabled), the send and accept stages of the referral can be combined into a single step. This is useful if there is no separate role in your service organisation that reviews the referrals and decides whether or not to accept into the service and also allocates the referral to a staff member/case worker.
This is configured for each service. Some services may have a service coordinator that allocates referrals to staff members and accepts referrals, whilst others may not. This settings is configured in the Contract Service form, in the field "Allow one click Send Accept".
Closing A Referral Prior to Enrolment
In some cases, it may be necessary to close a referral prior to enrolment. This could be the case, for example, if the client does not consent to receiving the referred service, cannot be contacted, or has received the service as part of a short engagement that does not require being included in a plan.
Closing a referral is permanent and cannot be undone.
To close a referral that has not been enrolled:
- Open the Referral
- Press the Change Status button on the menu bar. A dialog will open asking you to select the reason for deactivation
- Choose the deactivation type from one of the following:
- Successful Completion
- Unsuccessful Completion
- Client Non-contact
- Client Declined
- Provider Declined
- Deceased
- Transferred Out
- Closed
There are also deactivation options for "Master Referral", "Joined". These have special meanings to the system and we do not recommend that they be used.
Master Referrals are used for multiple service referrals. When a referral with multiple services is created, when the Send button is pressed, the system closes the referral by changing its status to "Master Referral", and then creates new referrals for each of its services and automatically moves them to the "Received" status.
The system sets the status of referrals to "Joined" when a referral was created as the result of an outbound referral (created from a plan) for an internal service with the "Join Me" option selected. When the resulting inbound referral is enrolled, its status is changed to "Joined".