Case Preparation, Referral, and Presentation
Referral
A referral is a request for a decision or service, not a transfer of accountability. Good referrals state the question, relevant history, what has already been tried, urgency, consent, and the referrer's contact. Check eligibility criteria and triage category; inappropriate referrals waste capacity and delay other patients.
Preparation
Preparation is a clinical task. Gather the current problem, relevant history, medicines, investigations, risk, patient goals, and any capacity or safeguarding issues. Identify the decision the team must make and the options available. Confirm the patient knows the case will be discussed and has agreed to information sharing.
Presentation
Use a structured summary: who the patient is, why now, key findings, what has been tried, the specific question, and options with their trade-offs. A common format is a one-page profile plus a three-minute verbal summary. Present facts and uncertainty separately; avoid a narrative chronology that buries the question. Finish with the decision required and by when.
Traps
Typical question traps include presenting a case with no clear question; referral without consent or with consent assumed; confusing referral with acceptance; overlong presentations that crowd out discussion; and omitting the patient's own goals. Another trap is presenting only confirming evidence and hiding discordant findings.
Rule of thumb
No case without a question; no question without the data to answer it. If the team cannot state the decision in one sentence, the preparation is incomplete.