The Art of Referral

The increasing complexity of primary pediatric care is focusing renewed attention on the relationship between the pediatrician and emergency department (ED) physician. Primary-care pediatricians and emergency physicians (EP) are colleagues in the provision of coordinated care to pediatric patients. Whether referral is made to an ED specializing in pediatric emergency medicine or to an ED serving primarily adults, pediatricians and EPs must communicate effectively to provide the best possible patient care. In this article, we discuss the general process of referral, and present the example of Children's National Medical Center (CNMC), Washington, DC, as a successful system for processing referrals in the ED. We review the necessary information for the smooth transition of care from the physician's office to the ED. Potential problem areas and solutions are discussed. Checklists with potential value for both pediatricians and EPs are presented. WHY PEDIATRICIANS REFER TO EDs The reasons for referral generally fall