Complex or undifferentiated medical problems

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Useful Management Information

Laboratory tests should be limited and dependent on the history and examination.
Available depression tools include:
PHQ-2  – 2 question screening tool
K-10  – 10 question screening tool
Consider referral to dietitian if significant weight loss reported.

Minimum Referral Criteria

Category 1	Unstable co-morbidities which require early medical intervention to prevent further deterioration that may result in emergency hospitalisation Recent discharge from hospital or emergency department (<4 weeks) and need for ongoing surveillance and optimisation of co-morbidities Acute exacerbation of chronic medical condition which impacts on other co-morbidities and requires close monitoring Rapidly progressive or recent onset of undifferentiated syndromes (eg pyrexia [T<39°C] of unknown origin, marked decline in cognitive function, generalised sub-acute myalgia/arthralgia or other undifferentiated rheumatic syndromes, generalised lymphadenopathy) for which definitive diagnosis and/or management plan is required Fatigue lasting more than 3 months and any of the following: significant weight loss (≥5% body weight in previous 6 months) recent and/or progressive onset in previously well, older patient dyspnoea or other features suggestive of cardiorespiratory compromise unexplained lymphadenopathy presence of fever
Category 2	Stable co-morbidities that require risk assessment and medical optimisation Stable or slowly progressive undifferentiated syndromes (eg fatigue, decline in cognitive function, generalised lymphadenopathy) for which definitive diagnosis and/or management plan is required Chronic symptoms (eg dyspnoea, dizziness, imbalance) or condition requiring investigations and management to minimise long term impairment Chronic symptoms causing significant social/economic/functional impairment Diagnostic dilemmas requiring further investigation or confirmation
Category 3	Multiple co-morbidities in need of regular review where referral to two or more specialty clinics imposes an unacceptable burden on patients Non-progressive fatigue lasting longer than 3 months that remains unexplained despite detailed investigation
If your patient doesn't meet the minimum referral criteria If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested: Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.) Please note that your referral may not be accepted or may be redirected to another service

Standard Referral Information

Reason for request

To establish a diagnosis
For treatment or intervention
For advice and management
For specialist to take over management
Reassurance for GP/second opinion
For a specified test/investigation the GP can't order, or the patient can't afford or access
Reassurance for the patient/family
For other reason (e.g. rapidly accelerating disease progression)
Clinical judgement indicates a referral for specialist review is necessary

Relevant clinical information about the condition

Presenting symptoms (evolution and duration)
Physical findings
Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
All conservative options that have been pursued unsuccessfully prior to referral
Body mass index (BMI)
Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes, BMI), noting these must be stable and controlled prior to referral
Any special care requirements where relevant (e.g tracheostomy in place, oxygen required)
Current medications and dosages
Drug allergies
Alcohol, tobacco and other drugs use

Patient's Demographic Details

Full name (including aliases)
Date and country of birth
Residential and postal address including whether patient resides at an aged care facility
Telephone contact number/s – home, mobile and alternative
Medicare number (where eligible)
Name of the parent or caregiver (if appropriate)
Name of delegate and contact details (Department of Corrective Services)
Preferred language and interpreter requirements
Identifies as Aboriginal and/or Torres Strait Islander
Any special needs, access requirements and/or disability relevant to the referral

Referring Practitioner Details

Full name
Full address
Contact details – telephone, fax, email
Provider number
Date of referral
Signature
Nominated general practitioner’s details (if known), if the nominated general practitioner is different from the referring practitioner

Other relevant information

Willingness to have surgery (where surgery is a likely intervention)
Choice to be treated as a public or private patient
Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

Essential Referral Information

Relevant medical history, co-morbidities (including depression and anxiety) and medications (including an assessment of adherence)
Details of all treatments offered and assessment of efficacy
A clear indication of clinical question that the specialist is required to address
Details of any functional decline or cognitive impairment
FBC
ELFT
ESR
TSH

In cases of suspected malignancy, pyrexia of unknown origin or generalised lymphadenopathy, also include:

CT scan chest/abdomen/pelvis
ANA plus full antibody profile if ANA > 1/640
Serum protein electrophoresis

In cases of myalgia/arthralgia, also include:

CPK results
ANA plus full antibody profile if ANA > 1/640

In cases of poorly controlled diabetes, also include:

HbA1c

In cases of suspected or known cardiorespiratory disease, also include:

Chest X-ray

In cases of unexplained fatigue of recent onset, also include:

Impact on daily life and work (including falling asleep while driving)
CXR
Urinalysis results
Calcium
ESR/CRP
Iron studies
CPK (if muscle weakness or pain)
Vitamin B12 & folate

If a specific test result is unable to be obtained due to access, financial, religious, cultural or consent reasons a Clinical Override may be requested. This reason must be clearly articulated in the body of the referral

Additional Referral Information

Existing psychosocial issues and supports
Copies of discharge summaries and outpatient letters relating to encounters with other specialists
ECG
BNP (if available)
Magnesium and phosphate results (if appropriate)
Documentation relating to past hospitalisations and clinic visits for anxiety/depression (if appropriate)
Background information on occupational history and past infectious diseases (if appropriate)

Send Referrals To

Smart Referrals

Coming Soon

Internal Referrals

Internal Medicine (E-Blueslips)

Fax

5687 4497

Post

Booking and Referral Centre
Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215

Enquiries

1300 559 083

Service Availability

Facilities

Gold Coast University Hospital

Robina Hospital

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.