Consultation procedure

  1. Referrals must be made through the clinical coordinator who will obtain basic information on the case and the referring clinician. A "case" may be an individual, family, community group or agency.
  2. All referred individual and family cases must have an identified clinician responsible for their ongoing care. The CCS is not intended as a replacement for care but a supplement to mainstream care. When no primary care clinician or mental health professional is involved with the case, the coordinator may assist in finding one. The service cannot respond to emergencies for which the usual hospital care should be sought.
  3. The reasons for referral, specific needs for language interpreters, culture brokers and other resources should be identified at the time of intake. On the basis of this information, the clinical coordinator will assign one or more consultants to conduct the assessment.
  4. The consultants will meet with the patient and, when available, with the referring clinician. Whenever possible this will occur in the offices of the referring clinician. This will ensure that the consultation process takes place in a setting familiar to the patient and maximize the transfer of knowledge. The consultee and their staff will be invited to attend a clinical case conference of the CCS team where the case will be discussed, formulated and specific recommendations proposed.
  5. Initial feedback in the form of a telephone call and/or a brief letter will be sent to the referring clinician as quickly as possible (within 1-2 weeks). This first consultation note will emphasize treatment recommendations.
  6. A more detailed case formulation and consultation will be prepared by the consultant following the guidelines for the cultural formulation. After discussion and review at a CCS meeting or by one of the CCS clinical directors, this full consultation will be forward to the consultee and a copy sent to the patient’s medical file.
  7. Records on the consultations will be maintained for research purposes in a locked filing cabinet in the CCS research office. Clinical records will be maintained in the JGH OPD files for JGH patients or in the usual hospital or clinic records for patients seen at another institution. Strict confidentiality will be maintained at all times.
  8. CCS consultations and staff will be available for follow-up reassessments as needed.
  9. CCS staff will provide ongoing supervision, and inservice training related to specific cases or general themes.
  10. Consultees and patients, who give their informed consent, will be contacted to obtain their assessment of the usefulness of the CCS consultation as part of an ongoing research project and quality assurance.
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