TY - JOUR T1 - What is the effect of re-introducing a clinical conversation into urgent referral pathways? JF - Future Hospital Journal JO - Future Hosp J SP - 134 LP - 137 DO - 10.7861/futurehosp.4-2-134 VL - 4 IS - 2 AU - Ivan LeJeune AU - Rebecca JA Sims AU - Hugh Porter AU - Guy Mansford AU - Anastasios G Gazis Y1 - 2017/06/01 UR - http://www.rcpjournals.org/content/4/2/134.abstract N2 - Demand for assessment at the acute medicine receiving unit (AMRU) regularly exceeded the capacity of the AMRU to assess and treat in a timely way. Audit work suggested that 28% of patients arriving could have had their care delivered in an alternative setting by a service that was already available. The system of referral was redesigned to re-introduce a mandatory GP to consultant clinical conversation to enable navigation of patients to the most appropriate clinical setting. This has relieved pressure on the AMRU and means that patients are directed to the right clinical setting, first time, more of the time. The numbers of patients presenting to the AMRU following such a conversation who could have had care delivered in an alternative setting has dropped below 5%. The ambulatory care rate for the AMRU has been maintained at 43%. ER -