During the Initial Provider Call

CONSIDERATIONS

If the bleeding disorders treatment team is in the best position to make the initial referral to an inpatient or residential behavioral health treatment facility, please consider the following recommendations for the initial call (bleeding disorder provider to facility). If the bleeding disorders treatment team is not directly communicating with the facility, encourage the referring provider to use this language.

Do

  • Be honest, direct, and brief.

  • Refer to the bleeding disorder as a stable, chronic, and well-managed health condition.

  • Limit medical terminology (words like “prophylaxis” or “factor”).

  • Suggest that they contact the bleeding disorders treatment team if they have any questions or concerns.

  • Let the facility know that the bleeding disorders team is available to support the patient during and after their treatment at the behavioral health treatment facility.

Do Not

  • Bring up the patient’s bleeding disorder initially.

  • Mention IV or injectable medication until asked.

  • Provide complicated explanations of bleeding disorders.

  • Focus on potential complications related to bleeding disorders.

    • “Patient has a stable, well-controlled medical condition with an established treatment plan that can be easily managed in the community and at your facility.”

    • “If my patient did not have a [mental health condition or substance use disorder], they would be living a full, active life in the community.”

    • “With access to medication in the stable environment that your facility provides, we are confident that my patient’s bleeding disorder will be sufficiently controlled throughout their stay at your facility.”

    • “This patient has a treatment team available to answer any questions you might have and support you during the patient’s stay at your facility. Can I connect their treatment team with a provider at your facility for a “doctor-to-doctor” call?”

    • “Would it be helpful if I got a letter from the patient’s treatment team to assure the facility that the patient is stable from a bleeding disorders perspective and appropriate for admission?”

    • “Patient has a chronic health condition that they manage independently. However, they may need some reasonable accommodations to ensure access to your facility.” 

    • “Patient has a well-controlled medical condition and self-administers medication that will be taken in private and stored at the facility.”

    • “The patient’s bleeding disorder treatment team believes that it is appropriate for the patient to self-administer their bleeding disorder medication both at home and at your facility.”  

    • “Many people with bleeding disorders, including this patient, self-administer bleeding disorder medicine intravenously or by injection to prevent bleeding. This medicine is very important for maintaining the patient’s health and medical stability and needs to be continued while at your facility.”

    • “The patient is fully competent to self-administer their bleeding disorder medication and does not require medical supervision for this process. A staff member may need to monitor the infusion process to ensure that no other substances are infused.”  

    • Bleeding disorder medication is not a pain reliever. It is taken to stop the bleeding and allows the blood to clot. Treating bleeds early avoids complications and long-term disability and gets people back to their regular activities. 

    • People with bleeding disorders do not require laboratory work on a consistent basis that would take them away from the facility.

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