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The purpose of this article to study referrals to our hand service to find out how long they had been waiting and with what sort of clinical conditions. The Department of Health monitors outpatient's waiting time as the percentage of patients seen within a 13‐week target. This target does not include patients referred by consultants or other health professionals.

All the referral letters from other consultants or healthcare professionals still awaiting appointments were collected. The referrals were read and studied to ascertain the most likely diagnosis. This was recorded along with the source of the referral and the details to whom the referral was made. The date of the referral letter being received by the department (date stamped) was also noted.

A total of 157 referrals from consultants or healthcare professionals were waiting outpatient dates. The median waiting time was 448 days (range 20‐952 days). The most frequent source of referrals was from the orthopaedic department. Carpal tunnel syndrome was the most common problem awaiting an outpatient appointment.

The wait for a clinic appointment for these patients is long. This has come about as the result of the fact that the government targets for outpatient waiting times have been set for GP referrals alone and exclude referrals that have been made by other consultants or other healthcare professionals. This is a clinical governance issue for the Hospital Trust, the Primary Care Trust and for general practitioners.

The Leeds Autism Diagnostic Service (LADS) is an all IQ service accepting professional and self-referrals, from age 18, for diagnostic assessment. LADS is unusual compared to other diagnostic services in England, in that it accepts self-referrals. The purpose of this paper is to compare diagnostic outcome between self-referrals and other referral sources.

This is a service evaluation of all 692 referrals for diagnostic assessment into LADS, over a three year period, from 2016 to 2018. The diagnostic outcomes were compared between self-referrals and other referral sources. Secondary analysis looked at age and gender differences between these groups.

There were 98 self-referrals over three years with autism diagnosed in 65 per cent. In total, 594 other referrals were received during this time period, with autism diagnosed in 44 per cent. This showed a significant difference of 21 per cent with 95% confidence intervals of 10–31 per cent (p=0.0001) using a n−1 χ² test. In total, 59 per cent of self-referrals were from patients identifying as female, which compared to 35 per cent identifying as female from other referrals. This was a difference of 24 per cent with 95% confidence interval of 14–34 per cent (p<0.0001) on the n−1 χ² test.

Factors which may influence the ability to generalise from these results are: that LADS covers a large mainly urban and suburban area with a range of ethnic and socioeconomic diversity; that LADS is an all IQ service unlike some other autism diagnostic services; historical and service-related factors unique to Leeds may be dissimilar to other locations. It was beyond the scope of this evaluation to perform a qualitative analysis to compare the referral sources, but this may be an area for further study.

This evaluation supports the use of a self-referral route for adult autism diagnostic services on a local level and may support its use more widely in other services.

This evaluation, in demonstrating proportionately significantly higher autism diagnosis from self-referrals is likely to be reducing the work load of professionals who would normally make referrals. Alternatively, it may be capturing a subgroup of the autism population who would not otherwise have sought diagnosis. In either scenario, it supports and is consistent with a patient centred approach to accessing appropriate diagnostic services.

The authors are not aware that any previous evaluation of this nature has been conducted and feel this evaluation supports the use of a self-referral pathway in adult autism diagnostic services.

A referral channel is a special type of information channel, one that is missing in standard discussions of the promotional mix. In a referral channel, one firm is in a position to give information about another firm′s products to potential customers of the latter. Qualitatively different types of referral channel exist and must be managed by different forms of co‐operative strategy. Points out the significance of referral channels to a firm′s environmental analysis and business‐unit strategic planning.

People with an intellectual disability are at an increased risk of developing a mental illness. An estimated 50 per cent develop a significant psychiatric problem at some point in their lives. Since the shifting trend to treat and manage individuals in the community setting, there are concerns over the lack of guidance of how intellectual disability mental health services in the community should be organised. This paper aims to address this issue.

Details of all new referrals made to the mental health of intellectual disability team in Dartford, Kent over a 12‐month period were collated and a questionnaire was used to gather retrospective data of each referral pathway.

There were 50 patients referred in total, with the primary source being GPs (58 per cent). In total, 40 per cent of all referrals were considered to be inappropriate for the mental health of intellectual disability team and the majority of these originated from the adult mental health and child and adolescent mental health service teams.

These findings identify areas of focus for closer liaison with colleagues to improve the quality of referrals and to reduce the demands placed on our service.

The literature on job networks predicts that employees referred through networks would be better matched and mentored and thus would have lower turnover. However, existing research on this question has neglected the ways in which network effects are contingent upon firm organization. Using the personnel records of a large retail bank, we examine the relationship between network recruitment and turnover among new employees. There was no significant difference between network referrals and non-referrals, but referrals eligible for the employee referral program did have lower turnover. These results are explicable in light of the bank’s organization.

Recent labor market research has called into question whether social capital effects are causal, or are spuriously due to the influence of social homophily. This essay adopts the demand-side perspective of organizations to examine the causal status of social capital. In contrast with supply-side approaches, we argue that homophily is a key mechanism by which organizations derive social capital. We develop an approach to bolster inferences about the causal status of social capital, and illustrate these ideas using data from a retail bank.

Late nephrology referral, a problem currently identified across many high income countries, has been associated with reduced opportunities for delaying or halting the progression of chronic kidney disease (CKD), delayed dialysis initiation, reduced choice in treatment modality, increased morbidity and hospitalization, and premature death. Despite a recent finding that the progression of CKD nearly always presents warning signs, and despite the fact that all Canadians are entitled to receive medically necessary health care free at the point of patient entry, each year in the province of British Columbia (BC) a substantial number of people with CKD experience late or no referral to nephrology care prior to requiring renal replacement therapy. A subset of these CKD patients experience no referral and “crash” onto dialysis (experience an acute or emergent start). Existing research has not fully explored the range of potential health determinants that may affect the timing of nephrology referral. This paper adopts a “determinants of health” framework and assesses the impact of a variety of indicators on patients’ physical health, demographics, socioeconomic status, social support, geographic and health system characteristics. Using a late referral definition of <3 months and data on BC patients who began dialysis between April 2000 and March 2003, multiple regression analysis indicates that the following determinants have an independent effect on the timing of referral: cause of end-stage renal disease (p=<0.0001); age (p=<0.0001); race/ethnicity (p=0.0019); English ability (p=0.0158); marital status (p=0.0202); proximity to care (p=0.0118); and, “age by first language” (p=0.0244).

From the supplier firm's perspective, a referral is a recommendation from A (the referrer) to B (the potential customer) that B should, or should not, purchase from C (the supplier firm). Thus, as referrals are for a specific supplier firm, they should be viewed as part of the supplier firm's marketing and sales activities. We recognize three types of referrals – customer-to-potential customer referrals, horizontal referrals, and supplier-initiated referrals – that have critical roles in a potential customer's purchase decision. We develop the concept of referral equity to capture the net effect of all referrals for a supplier firm in the market. We argue that supplier firms should view referral equity as a resource that has financial value to the firm as it affects the firm's cash flows and profits. We offer strategies firms can use to manage referrals and build their referral equity and suggest a research agenda.

This paper combined an at-destination decision-making model with the theory of tie strength to find out information related to the referrals that travelers received and used at a major tourist destination in the southeastern United States. At-destination decisions included lodging, eating and dining, entertainment, recreation, and travel. The data indicated eating and dining, recreation, and entertainment decisions are made in large numbers at the destination. The first research question involved referral source and frequency for at-destination decisions, revealing many third-party decision-makers. Friends and family members were the most requested and local residents the least requested referral sources. The second research question inquired as to whether satisfaction scores from the referred experience differed across referral source. The researchers suggested that referrals have different perceived levels of trust, expertise, and ties, and potentially will render different sales levels. Due to this, the satisfaction outcome was measured by referral source. Results showed that referred satisfaction scores were highest from local resident referrals followed by friends and relatives – one a strong tie and one a strong–weak tie. Finally, more neutral satisfaction scores were reported from other information sources. The article closes by offering possible explanations for these differences and by providing suggestions for additional at-destination decision-making and outcome research.

Are White and Asian job applicants advantaged in access to professional jobs relative to Black and Latinx job applicants at the initial screening stage of the hiring process? And, are the mechanisms of advantage for White applicants different than the mechanisms for Asian applicants? In this chapter, the author proposes a theoretical framework of “parallel mechanisms” of White and Asian advantage during hiring screening – that White and Asian applicants are advantaged compared to Black and Latinx applicants, but that the mechanisms of advantage subtly differ. The author focuses specifically on mechanisms related to two important factors at the hiring interface: referrals and educational attainment. The author applies the concept of parallel mechanisms to a case study of software engineering hiring at a midsized high technology firm in Silicon Valley. The author finds that at this firm, White applicants are advantaged at initial screening relative to Black and Latinx applicants due to average racial differences in applicant characteristics – namely having a referral – as well as differences in treatment by recruiters. For Asian applicants, average racial differences in possession of elite educational credentials, as well as racial differences in recruiter treatment, explain the racial disparity in callbacks. The author discusses the implications of parallel mechanisms of advantage for racial inequality in a multiracial context, and for organizational policy meant to address racial disparities during organizational hiring processes.