EPA 3B: Engage in Collaborative Care - Referral

SCOPE OF WORK: This activity includes engaging in collaborative care between oral health care providers (e.g., dental specialties) and other health care professionals (e.g., medicine, nursing, nutrition, social work, pharmacy). Conducting safe, timely, effective, efficient collaborative care, verbal and/ or written is essential to providing optimal, person-centered, and equitable patient care. Referral to another health care provider when treatment is needed that is beyond the scope of the dental provider or when it is determined that the dental specialist or other health care provider has knowledge, skill, or ability beyond those of the designated care provider.

Domains of Competence

Person-Centered Care
Critical Thinking and Decision Making
Team Based Care
Biomedical Science Application
Self-Assessment

Knowledge

Roles and responsibilities of all members of the health care team (including all dental specialties)
Capability, knowledge, and skill that dental/non-dental health care professionals can provide to dental patients
Communication and collaboration with oral and other healthcare partners
ISBAR framework to communicate essential information
Criteria for determining if/when consultation and/or referral are needed
Process of referral and consultation (including informed consent, communication, documentation, follow up)
Required documentation specific to referral/consult in electronic patient record (EPIC Wisdom)

Skills

Recognize one’s limitations in scope of practice, skills, knowledge, and/or abilities
Recognize when patient would benefit from consult or referral
Identify when further information is needed from other professionals to make treatment planning decisions that optimize safety and treatment outcomes
Engage dental and non-dental health care professionals to assess, coordinate, and provide care that aligns with patient’s values and is safe, timely, efficient, effective, and equitable
Demonstrate teamwork and effective communication to facilitate collaboration
Engage in collaborative decision-making with intra- and inter-professional partners to address patient needs
Referral/consult, written and/or verbal, includes the elements of the ISBAR framework
Properly document referral/consultation to facilitate an effective handoff in electronic patient record (Epic Wisdom)

Referral	Meets Expectations of the Graduate	Progressing	Below Expectations	Critical Error

Decision to Refer	Appropriately identifies need to refer and to which dental professional(s) and/or other health care provider(s)	Recognizes value of referral but needs guidance to identify the appropriate dental professional(s) or discipline(s)	Does not recognize need to refer or suggests referral with an inappropriate discipline, neither of which compromises patient’s health	Fails to recognize need to refer that may compromise patient’s health
Referral Handoff/Process	Well-reasoned and well documented referral to another health care provider; clearly explains reason for and steps of referral to patient and obtains informed consent	Referral is appropriate but rationale for or steps in the referral process may not be clearly described or documented.	Failure to confirm and document patient handoff to the referred health care provider; patient not fully informed as to the purpose of the referral	Fails to obtain and document patient consent; Lapse in patient care that may compromise patient’s health
Communication of Referral	Referral, written or verbal, includes the elements of the ISBAR framework, and avoids dental jargon when communicating with providers outside of dentistry	Referral, written or verbal, may be missing one of the elements of the ISBAR, or request to other provider needs clarification	Referral is missing more than one element of ISBAR framework, making the request difficult to understand and may lead to inefficiencies or delay in patient care	Communication to health care provider is incomplete or/and has inaccuracies that could negatively affect patient’s health outcomes

*ISBAR – Introduction: Identify oneself and role in care. Situation: Reason for consult/referral. Background: Pertinent patient information (e.g., patient diagnosis). Assessment: Learner’s assessment of the situation. Request/Recommendation/Result: What information is needed; what is their recommendation; what you would like them to do; arrange follow-up (how and when). Rating on "Team-Based Care" for this encounter will be included for the assessment of this task.

Consult Local Anesthesia