Abstract

The project ‘Introduction of an online programme for the specialty referrals featuring an outlier patient manager’ is an initiative at Royal Blackburn Hospital that was run by a gastroenterology registrar and a foundation doctor from Nov-2016 to Mar-2017. It was developed on already available resources at zero cost. Initially, we replaced an out dated handwritten fax referral system with an online referral system based on the ‘Sun quest ICE Desktop System’. This platform conveniently combined valuable clinical information such as laboratory and radiology reports, discharge letters and the patients’ location. After 3 months of use, we assessed the online referrals and found:

• a very high number of gastroenterology referrals, approximately 140 per month

• a significant number of days of gastroenterology patients spent as outliers before transfer to our ward

Consequently, we developed an ‘online outlier’s manager’as part of the new referral system which is a shared list of patients that can be accessed through ICE. The gastroenterology team populates the list with patients referred to us and need to be taken over by our team. This allowed us to have a handover tool for the outliers and a patient tracker that the bed managers use to expedite the transfers to our ward. We audited the results of the project in three cycles.

The days for transfer of a gastroenterology patient to a gastroenterology ward from:

• AMU has decreased from 1.6 to 1.3 days (18%)

• an outlier ward has decreased from 5.3 to 3.9 days (26%)

The ratio of gastroenterology patients to general medical patients in our wards has increased from 63% to 69%.

In conclusion, by transferring patients to an appropriate ward, the overall turnover of patients has been increasing continuously from 87 total admissions to 119 and then to 131 patients over three week period (increase of 50%).