Criteria for referral to public hospital service
- Skin breakdown or infection, or both, secondary to severe contracture
- Metacarpophalangeal (MCP) joint flexion contracture greater than 30 degrees with functional impairment
- Proximal interphalangeal (PIP) joint flexion contracture greater than 10 degrees with functional impairment
- Recurrence of contracture after surgery with functional impairment.
Information to be included in the referral
Information that must be provided
- Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
- Range of measurement (ROM) measurements
- Details of functional impairment and how symptoms are impacting on daily activities including impact on work, study or carer role
- Details of previous medical and non-medical management including the course of treatments and outcome of treatments
- If referral relates to recurrence after surgery, details of the surgery including when and where procedure(s) were performed
- History of smoking
- If the patient is taking an anticoagulant medicine
- Statement about the patient’s interest in having surgical treatment if that is a possible intervention.
Provide if available
- If the person identifies as an Aboriginal and/or Torres Strait Islander
- If the person is part of a vulnerable population.
The Summary and referral information lists the information that should be included in a referral request.
Where appropriate and available the referral may be directed to an alternative specialist clinic or service.
- Vulnerable populations include:
- people from culturally and linguistically diverse backgrounds
- older Australians
- carers of people with chronic conditions
- people experiencing socio-economic disadvantage
- people living in remote, or rural and regional locations
- people with a disability
- people with mental illness
- people who are, or have been, incarcerated.
Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.
Referral to a public hospital is not appropriate for
- Palmar thickening or nodules without contracture
- Contracture without functional impairment
- Metacarpophalangeal (MCP) joint flexion contracture less than or equal to 30 degrees
- Proximal interphalangeal joint (PIP) joint flexion contracture less than or equal to 10 degrees.