INVESTNET
PROJECT
Increasing Utilisation of an Existing Inpatient Flow Pathway to a Model 2 Hospital
TEAM:
Ms Claire Crowley, Hospital Manager, MGH; Ms Patricia Moloney, Director of Nursing, MGH; Ms Fiona Sexton, CNM3 Patient Flow, MGH; Dr Anne Marie O’Flynn, Consultant, MGH; Dr Ceara Hart, Consultant, MGH; Dr Emma Jennings, Consultant, MGH; Dr Sean Manning, Consultant, MGH; Dr Muhammad Ahmed, Consultant, MGH; Dr Daniel Schmidt, Consultant, MGH; Dr John Kiely, Consultant, MGH; Ms Avril Dunlea, CNM, MGH; Ms Brenda O'Keeffe, CNM, MGH; Ms Lorraine Barry, CNM, MGH; Ms Katie Falvey, CNM, MGH; Ms Shona Rochford, CNM, MGH; Ms Kay Lucey, Discharge Coordinator, MGH; Ms Ann Higgins, Assistant Director of Nursing, MGH; Ms Louise Jones, Assistant Director of Nursing, MGH; Dr Ciara McGlade, Consultant and Chief Medical Officer, CUH; Professor Barry Plant, Consultant and Clinical Director for Medicine, CUH; Ms Aileen Horgan, Medical Directorate Manager, CUH.
LOCATION:
Mallow General Hospital (MGH)
THE PROBLEM:
Mallow General Hospital (MGH) is a model 2 hospital that underwent significant development in 2023 with the opening of 2 new wards comprising of 48 single rooms. An inpatient flow pathway was in place from Cork University Hospital (CUH) to MGH since 2014. However, despite increased capacity this pathway was being underutilised. It was identified that there was a general lack of awareness regarding the pathway. It was also identified that consultants in the referring centre found the process for referral and acceptance of patients cumbersome and inefficient. The aim of this project was to address the underutilisation of the inpatient flow pathway to MGH and increase the number of inpatients being transferred for completion of their medical care from model 3 and 4 centres within the region, with a particular emphasis on CUH.
THE SOLUTION:
A review of the pathway commenced 6 months prior to the opening of the new bed capacity. Patient suitability criteria and exclusion criteria were defined which were distributed in referring centres. A single phone line for referral to the consultant on call in MGH was established allowing immediate discussion and acceptance of patients. A video link was established for the consultants in MGH to log into the CUH medical handover morning meeting so patients could be identified and accepted early in their inpatient journey. Access to the CUH medical handover shared folder was provided to MGH. One of the new wards in MGH was ring-fenced for transfers from CUH. A patient flow CNM3 role was established in MGH to provide a communication link across sites.
BENEFITS:
In 2023, 187 patients were transferred into MGH by this pathway. Up to October end 2024 there have been 705 inpatient transfers. MGH is on target to accept over 800 inpatient transfers in 2024. A review of 167 inpatients (50% female and 50% male) transferred into one of the newly opened wards demonstrates the profile of patients accepted. The mean age was 78 (± 13) years. Thirty five percent of the patients were at least moderately frail. The mean and median length of stay in the referring centres was 4 (± 9) and 1 day(s) respectively. The mean and median length of stay in MGH was 10 (±9.5) and 7 days respectively. This reflects significant bed capacity returned to the larger regional centres as a result of the increased utilisation of this pathway.
PROJECT CONTACT DETAILS:
Dr Anne Marie O’Flynn, Clinical Lead, Mallow General Hospital.