angelina zande-wilkins - metro south patient flow program - metro south health central referral hub
TRANSCRIPT
PAH, QEII, LOGAN, BEAUDESERT, WYNNUM & REDLAND
• Building a patient centred, dynamic and sustainable multidisciplinary service to improve access to the right service; at the right time; using an integrated partnership approach between community, primary, and secondary care.
MSH CENTRAL REFERRAL HUB SERVICE DEFINITION
Outpatient
and Wait
Lis Audit
Service
Community
Referral
Service
Specialist
Outpatient and
Allied Health
Referral
Service
Outpatient
and Wait
List Audit
Service
Oral
Health
Service
CENTRAL REFERRAL HUB SERVICES
OBJECTIVES • Operationalise a ‘no wrong door”
philosophy
• ALL EXTERNAL REFERRALS – ONE NUMBER
• Improve patient access
• Load share across the HHS as appropriate and according to defined pathways
• Comply with Corporate Policy, Procedures, Standards and Data requirements
No wrong door
Consistent
Standard
Right Service
Right Time
OUTPATIENT REFORM STRATEGY
• Focusing on the interface between primary care and specialist outpatient care
CURRENT STATUS MSH CRH
• 132, 652 referrals received between 5th
May 2014 – 31st May 2015
• 150,648 calls managed through the Hub
– Oral Health: 115,569
– Community: 11,699
– Specialist Outpatient Clinical
5,056
– Specialist Outpatient Admin
12,144
– Wait List Audit: 6,180
• 40.3 FTE MSH Central Referral Hub
Staff:
– 30.3fte Administration
– 10.0 fte Clinical
• Nurse Unit Manager/Team
Leader (1)
• Clinical Nurses (7)
• Social Worker (0.8)
• Physiotherapist (1)
• Speech Therapist (0.2)
GO LIVE – 5TH MAY 2014…….
0
100
200
300
400
500
600
700
800
900
7am 8am 9am 10am 11am 12pm 1pm 2pm 3pm 4pm 5pm
4 42
254
425
533
587
643
711
785
843 845
MAY 2014 MONTHLY REPORTING
20%
30%
40%
50%
60%
70%
90%
80%
10%
20%
30%
40%
50%
60%
70%
90%
80%
10% 20%
30%
40%
50%
60%
70%
90%
80%
10%
FORWARD 12 MONTHS.............. MAY 2015
20%
30%
40%
50%
60%
70%
90%
80%
10%
10%
20%
30%
40%
50%
60%
70%
90%
80%
10%
20%
30%
40%
50%
60%
70%
90%
80%
MAY 2014 COMPARED TO MAY 2015
20%
30%
40%
50%
60%
70%
90%
80%
10%
10%
20%
30%
40%
50%
60%
70%
90%
80%
10%
20%
30%
40%
50%
60%
70%
90%
80%
REFERRAL PROCESS
ARMS (AMBULATORY REFERRAL MANAGEMENT
SYSTEM)
Clinically led system design that aligns with
the patient referral journey
Referral received Placed on Wait List
• EASY ACCESS
– NOVELL username and password
– MOs can access ARMs via Remote Access Token (RAS Token)
• PATIENT TRACKING
– Referral secured
– Correspondence retained
– Patient history noted
– Electronic triage recorded
ARMS TRIGGER POINTS – DATA ENTRY
Inbox
Registration
Hub Clinician
Facility / Specialty Work list
Outbox
ARMS INBOX
ARMS REGISTRATION SCREEN
ARMS SPECIALTY WORK LIST
ARMS OUTBOX
TRIAGE GUIDELINES
Identifies URGENT REFERRALS Checks for completeness Assesses patient needs
TRIAGE GUIDELINES
• Research to develop baseline criteria
• Meetings with Specialty Directors & Team
• Agreement across the HHS
• Endorsement
• Annual review
REFERRAL TRIAGE GUIDELINES TEMPLATE Referral Eligibility:
Logan Ph: Fax: Email:
PAH Ph: Fax: Email:
QEII Ph: Fax: Email:
Redland Ph: Fax: Email:
Category Definitions:
Category 1 I. Appointment within thirty (30) days is desirable; AND II. Condition has the potential to require more complex or emergent care if assessment is delayed; AND III. Condition has the potential to have significant impact on quality of life if care is delayed beyond thirty (30) days.
Category 2 i. Appointment within ninety (90) days is desirable; AND ii. Condition is unlikely to require more complex care if assessment is delayed; AND iii. Condition has the potential to have some impact on quality of life if care is delayed beyond ninety (90) days.
Category 3 i. Appointment is not required within ninety (90) days; AND ii. Condition is unlikely to deteriorate quickly; AND iii. Condition is unlikely to require more complex care if assessment is delayed beyond 365 days.
Clinical Triage Guidelines:
Conditions requiring immediate referral include:
Category
1. Urgent Seen within 1 month
2 Semi-Urgent Seen Within3 months
3. Routine Seen Within 12 months
Alternative Services:
Other Information:
CONDITIONS NOT SEEN:
CLINIC INFORMATION:
COLLABORATION & PARTNERSHIP
Strengthening the partnership between primary and secondary care; improving the delivery of outpatient services and health outcomes to the community.
• GPLO Program works in works in conjunction with the Metro South Health Central Referral Hub and with Medicare Locals
• The program has visited all GP Practices within Metro South Health
• GPLO Nurses review rejected referrals and follows up with the Referrer
• A contact support for General Practice
GPLO PROGRAM
MSHHS GP REFERRAL GUIDE
EDUCATION & TRAINING
CLINICAL AUDITING LONG
WAITS
MSHHS SPECIALTY REFERRAL
TEMPLATES
E-REFERRAL SOLOUTION
TRIAGE GUIDELINES
OUTPATIENT DISCHARGE
VIRTUAL HEALTH PRECINCT
MEDICARE LOCAL
COLLABORATIVE PARTNERSHIP
METRO SOUTH HEALTH GP REFERRAL GUIDE • Available online http://metrosouth.health.qld.gov.au/referrals • Updated 6 monthly • An external website is available for patients and GP’s to view information regarding
the Central Referral Hub.
PRIMARY CARE PARTNERSHIPS UNIT
“Building a patient centred, dynamic and sustainable multidisciplinary service to improve access to the right service; at the right time; using an integrated partnership approach between community, primary, and secondary care.”