Inter-hospital transfers - transforming clinical communication and clinical governance to enhance patient care

Abstract

Todd, J 1, Hopkinson, D, 1

Inter-hospital transfers – transforming clinical communication and clinical governance to enhance patient care

1. Patient Safety and Clinical Excellence Division, Austin Health, Vic Australia

Aim

To develop a standardised electronic referral tool to document medical handover received for incoming inter-hospital transfers. To develop an electronic communication dashboard to provide visibility of clinical information to support the safe transfer and coordination of care. Currently there is no agreed minimum information requirements or standardised process for documentation of inter-hospital transfers.

Methods

A working group was established in 2021 with senior representation from medical, nursing, administration and bed management stakeholders. The working group developed the minimum information requirements to be collected. Due to organisational resourcing barriers, the working group was put on hold in 2022 and re-established in early 2024. Extensive consultation with key stakeholders was conducted via online survey and in-person focus groups. Clinicians were invited to share their perceptions and points of view regarding current clinical workflows and essential technical requirements for the proposed solution. Each user requirement has been rated using the MOSCOW method to determine priorities.

Results

In-principle agreement has been reached on the minimum clinical information requirements, following an ISBAR structure. Survey results (n=31) and responses via focus groups have been collated and themed (dynamic, visibility, ease of access / familiar platform, single source of truth).

Conclusion

User requirements to be reviewed and considered by IT Business Analyst to determine potential technical solutions. Considerations for three possible solutions include Microsoft CRM, Cerner-based solution or a hybrid model. Proposed solution to be endorsed by the working group and user testing to follow.

Impact

By implementing a standardised organisation-wide process for the documentation and management of clinical information for incoming transfers, we will achieve improved information visibility and enhanced care coordination prior to patient arrival.