Transferring patients from one QHC hospital to another is sometimes unavoidable – our primary care hospitals in Trenton, Picton and Bancroft are not always able to provide the same specialized services as our secondary care hospital in Belleville. But with a little ingenuity, some patient transfers can be avoided, resulting in time and cost savings, reduced risk and a less stressful experience for patients.
In April, a large group of Quinte Health Care staff and physicians participated in an improvement event that took a critical look at patient transfers between QHC hospitals. The team identified many improvement opportunities, one of which involves health care providers using Ontario Telemedicine Network (OTN) to videoconference with patients in certain situations.
Picture this… a patient from the Trenton Memorial Hospital (TMH) inpatient unit requires a consultation with an orthopedic surgeon in the fracture clinic at Belleville General Hospital (BGH). She would normally need to be driven by the patient transfer service to BGH where she would wait on a stretcher until the surgeon is ready to see her. She would have her 15-minute appointment and then would be driven back to TMH. The entire trip could take up to three hours and cost roughly $320.
Ruthann Hubbs, Manager of Patient Services at TMH, explains that many fracture patients from the TMH inpatient unit don’t physically need to go to the BGH fracture clinic to meet with the orthopedic surgeon – meeting via OTN teleconference works just as well, if not better, in many cases. The patient can be in a room at TMH with her nurse, occupational therapist/physiotherapist and her family while speaking to the doctor via OTN teleconference. They can chime in to provide the doctor information as needed instead of the patient being left to answer on her own. The quick, 15-minute OTN consultation leaves everyone fully understanding the care plan, which can then be implemented right away.
“By avoiding an unnecessary transfer, the patient doesn’t miss any meals, treatment or rehab,” explains Ruthann. “She is supported by her family and care providers on her unit and is fully informed of the plan. Talk about patient-centred care! We’ve only just begun exploring this technology as an option and it has proven very beneficial in early trials with orthopedic doctors.”
By avoiding an unnecessary patient transfer, it also frees up a transfer vehicle for a more urgent patient. Since beginning patient transfer improvement efforts in April, QHC is more effectively utilizing Spectrum Patient Services for transfers and has reduced its use of paramedic services for patient transfers – by 18% for non-life-threatening interfacility transfers, and by 82% for scheduled interfacility transfers.
“These are fantastic improvements that leave more ambulances on the road for emergencies,” said Beverly Shepherd, Clinical Process Improvement Coach.
Janet Newbatt, QHC’s Telemedicine Coordinator, has been discussing the benefits of telemedicine with physicians and recruiting them to trial the technology. Some have been hesitant but a few have embraced it.
“There’s always a learning curve with technology but there’s support available,” said Janet.
The goal is to have more physicians – including those in Trenton, Picton and Bancroft – to utilize telemedicine as well as other health care team members such as respiratory therapy and physiotherapy.
“It’s not black and white,” said Janet. “There are some limitations to how we can use telemedicine but also so many opportunities. Saying yes to trialing it doesn’t mean you have to use it all the time but it can be really helpful in certain situations. We just need some more good champions to really get it going.”