# Optimizing paediatric specialist referrals for short stature in an era of multiple growth hormone indications

## TL;DR

This paper outlines the development of guidelines for referring children with short stature to specialists in Canada.

## Contribution

The study introduces a consensus-based referral algorithm and form for timely specialist referrals in Canadian pediatric care.

## Key findings

- A referral algorithm was developed to guide primary care providers in identifying children with atypical growth.
- A referral form was created to ensure relevant information is transmitted to secondary care consultants.
- Consultations with healthcare professionals identified red flags for early specialist referral.

## Abstract

The assessment of growth during infancy and childhood is an essential component of paediatric medicine, as atypical growth may point to the existence of an underlying health condition. To reduce morbidity, it is vital that treatment for growth disorders is provided in a timely fashion. However, although there are guidelines regarding referral criteria for short stature in Europe and the USA, there are no such guidelines in Canada. To address this, a series of consultations and workshops with paediatricians, paediatric endocrinologists, family physicians and nurses were held, with the aim of developing a consensus-based set of recommendations for children in Canada showing atypical growth and to identify red flags for children who might benefit from early referral. To achieve this, a referral algorithm and referral form for primary care providers were developed to ensure timely and appropriate referrals, and transmission of the most relevant details to the secondary care consultant.