Revamping the patient transfer workflow to utilize morning NEATS service for early acute to convalescent patient transfer

Abstract Description

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Authors (including presenting author) :

Wong YND(1), Lee MY(1), Choo KL(1), Tong WCM(1), Cheung PK(1)

Affiliation :

(1) Department of Medicine, North District Hospital

Introduction :

Convalescent-Rehabilitation (CR) care for medical patients in North District Hospital is mainly supported by hospital in another district. Patients require CR service will undergo a transfer process involve various departments, including TPH, NEATS and porter service. Early patient discharge allows patient to receive CR care promptly and helps to alleviate the problem of access block. Therefore, when patients are suitable for transfer, optimizing the NEATS morning service enables early discharges and promotes the efficient use of resources. However, the utilization of the morning NEATS was not satisfactory. To tackle the issue, it is essential to identify and analyze the root cause of problems in the process by RCA, and implement recommendation to promotes early patient transfer to convalescent hospital by revamping the transfer process.

Objectives :

1) Identify and analyze the root cause of problems in current booking process 2) Revamp the process of patient transfer 3) Increase the utilization of morning NEATS service.

Methodology :

Define the problem: Poor utilization of morning NEATS service Identify issues contributing to the problem: 1) Awareness of role and responsibility by the department involved 2) Availability of discharge document 3) Intra-departmental coordination Root cause of the problem: The awareness of the role and responsibility by the departments involved in the process. Relevant personnel must be aware of their role and responsibility to ensure smooth operation of this transfer process. Recommendation and Implementation: 1) Workflow with timeline of the process is revamped and aim to improve the awareness of the role and responsibility by the departments involved. 2) Designating a coordinator to organize daily booking facilitated better communication with coordinator in convalescent hospital for identifying patients who are suitable for morning transfer. 3) Transfer priority was given to those with discharge document which encouraged physicians to delivery documents on time and avoided delay of transfer due to unready document in the morning.

Result & Outcome :

The utilization rate of morning NEATS service increased from 55% (Average, August to October 2018) to 100% (November 2018). The number of patients transferred has almost tripled, increased from 25 (Average, August to October 2018) to 70 (November 2018). With the revamped workflow in place, the results are promising as shown by the drastic increase in utilization rate of morning NEATS service and the number of patients transferred. Staff in the department involved are also satisfied with the process of the workflow.