Comms Lab: Episode 37
Mastering The Phone Referral: Comparing Structured Approaches
As clinicians, we engage in negotiation every day – with our patients and with our colleagues.
Phone referrals, Consults, Admission Handoffs – whatever you want to call them – are one of the biggest communication challenges in medicine. That’s why researchers have developed structured approaches to these conversations.
In this video I’ll be examining 3 different approaches: ISBAR, PIQUED, and The 5Cs. I’ll give examples of each, look at their origin and evidence base, and give you my opinion on the pros and cons based on real-life experience.
Got feedback for me? Great! I’m always trying to make my videos better and more relevant. Let me know what you think in the comments section, or anonymously via jotform
- Request / Recommendation
- Preparation and Review
- Identification of Involved Parties
- Educational Modifications
- Debrief and Discuss
- Core Question
- Close the Loop
0:00 – Phone Referrals – Why Structure them?
0:38 – ISBAR
1:22 – PIQUED
1:54 – The 5Cs
2:37 – So which is the winner?
- Richards H. Mastering The Phone Referral: Comparing Structured Approaches. 2022
- Richards H. Mastering the Phone Referral: 5 Things You Must Understand BEFORE You Call. 2022
- Richards H. Dealing With Referral Pushback: 5 Simple Strategies. 2022
- Richards H. Graded Assertiveness: What’s the Best Approach? 2022
- Burgess A, van Diggele C, Roberts C, Mellis C. Teaching clinical handover with ISBAR. BMC Med Educ. 2020 Dec 3;20(Suppl 2):459. [ISBAR]
- Chan T, Orlich D, Kulasegaram K, Sherbino J. Understanding communication between emergency and consulting physicians: a qualitative study that describes and defines the essential elements of the emergency department consultation-referral process for the junior learner. CJEM. 2013 Jan;15(1):42-51. [PIQUED]
- Kessler C, Kutka BM, Badillo C. Consultation in the emergency department: a qualitative analysis and review – PubMed (nih.gov). J Emerg Med. 2012 Jun;42(6):704-11. [The 5Cs]
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A path to highly effective communication skills
Hayden is an emergency physician at University Hospital Geelong and a senior lecturer at Deakin University, Geelong. He is somewhat obsessed with the science and art of effective communication, and in particular: difficult conversations. He believes that we can all get better at having difficult conversations, and that the process of learning to do so can be seriously fun.
Hayden is also an avid but terrible surfer, ad hoc gardener, and dad to two awesome kids.