The Ministry of Health and Family Welfare (MOHFW) has issued new guidelines to improve patient referrals and emergency care coordination within Delhi’s healthcare system. These guidelines have been issued in the form of a referral policy.
Key Measures
The policy discourages unnecessary transfers between tertiary hospitals. Referrals will only be accepted for unavailable services as outlined in the Citizen Charter. All transfers require prior communication and confirmation between sending and receiving hospitals.
Secondary hospitals must refer patients only to designated tertiary hospitals based on capacity and capabilities. Similar protocols apply for reverse referrals.
Resuscitation and first-aid are mandatory before referral. Patients should be stabilized using Centralized Accident and Trauma Services (CATS) ambulances whenever possible.
Hospitals must maintain a referral register. CATS personnel or referring hospitals are obligated to report any denial of registration, treatment, or admission. Uniform referral forms signed by individual doctors are required. Generic stamps are prohibited.
Terminally ill or brain-dead patients are generally not referred unless organ transplantation is a possibility, following patient counseling.
Patients referred for diagnostics or specialist opinions will be returned to the referring hospital after completion.
A revived system from the COVID-19 pandemic will display daily ICU, PICU, NICU, and labor room bed occupancy twice daily.
Each hospital will conduct monthly reviews of their referral processes.
The referral policy will be evaluated quarterly to identify areas for improvement.
Ambulance Management
Hospitals will submit data on required ambulances based on past usage. Surplus ambulances may be allocated to CATS. Hospitals will collaborate with CATS to park ambulances and ensure their functionality.
CATS ambulance personnel will report to hospital nodal officers and assist with patient care services in the emergency department when not transporting patients.
Tertiary hospitals will provide regular training for CATS ambulance attendants and EMTs. Both hospitals and concerned authorities will conduct regular audits of CATS ambulances.
AIIMS Support for Implementation
The All India Institute of Medical Sciences (AIIMS) will assist in policy development and implementation through activities like:
- Conducting a baseline study to assess hospital resources.
- Sharing emergency care clinical templates and standardized referral forms.
- Gathering referral data.
- Training hospital staff on emergency care system strengthening.
Future Considerations
Inclusion of private hospitals in the emergency care network is being explored.
A dedicated fund will be established for unforeseen expenses related to emergency care.
