Mocking at the Government’s claims of streamlining referrals especially for expecting mothers, patients are being sent to LalDed Hospital with notes scribbled by doctors on paper scraps, skipping documentation recently mandated to ensure patient safety at both referee and referred institutions.
A source at Kashmir’s tertiary care maternity hospitalLalDed said that documents of patients referred to the hospital from peripheralinstitutions reveal the “callousness” of doctors while sending patients.
Most referral papers of patients received at LalDed Hospitalin April, the source said, were a proof of how healthcare was deterioratingwith unnecessary referrals. “Some referrals have been scribbled on the notebookpages, some on the plain paper while others, if made on hospital cards, bear noinformation on who referred the patient and why,” the source said.
In February this year, health and medical educationdepartment had formulated standard operating procedure for ensuringaccountability and safety of patients.
Directions had been passed to all healthcare institutionsthat whenever a patient was referred, the referral must bear the name,signature, seal, designation and registration number of the doctor making thereferral.
Government had also mandated that a patient being referredin an ambulance be accompanied by a medical attendant or ASHA worker”well-versed” with resuscitation drill. The patient upon reaching thetertiary-care hospital must be “handed-over” to the doctor on duty “under properreceipt indicating date and time of handing over the patient”.
After being received by doctor-on-duty, the Registrar onduty would need to be informed about the patient, the latter taking on themanagement of the patient from thereon “within shortest period of time”
A senior doctor at LalDed Hospital alleged that noarrangements had been put in place in peripheral hospitals to reduce theunnecessary referrals to LalDed Hospital.
“LD is a tertiary care hospital where the focus should havebeen on high risk cases rather than providing services that can very well bemade available in a primary health center as well,” she said.
The doctors said that north Kashmir continued to have thematernity services hinged on referring patients. “After 4 pm, most of thehospitals in the northern districts have only one doctor in the hospital whosejob is scribble note to refer patient,” she said.
Another doctor at LD Hospitals said that the directorate hadfailed to create functional 24×7 maternity centers which was the basic cause ofunnecessary referrals. “They have their staff scattered at places where thereis no role for them,” the doctor said urging the Government to focus oncreating secondary level referral centers at the upcoming Government MedicalColleges Anantnag and Baramulla. “Women in Kashmir will only then have somedecent maternity services here,” she said.
Director Health Services Kashmir, DrKunzes Dolma when askedabout the laxity in patient referrals to LalDed Hospital said that herdepartment was “sensitizing doctors” about the referral procedure.
“The attitude of healthcare workers in Kashmir needs to bechanged and we are working towards it,” she said adding that “it was bound totake time”.
“Things cannot change overnight,” she said while referring toSOPs.