Coordination among emergency services. An effective model for healthcare planning

Joan Antoni Oliva, Jaume Monmany, Lluís Pascual, Josep Maria Guardiola, Eva Coma, Pilar Madrid, Rosa Teixell, Francesc Ferrer, Guillermo Vázquez

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To evaluate, through an intervention study with historic controls, the optimization of patient transfer from the emergency service of a high complexity hospital -originating centre (OC)- to a hospital of less complexity -recipient centre (RC)- in winter. Material and method: The intervention consisted in the creation of the following resources and mechanisms: criteria for selection of patients suitable for transfer, exclusive communication system, designation of a time band for the transfers, obtaining pending results from complementary examinations carried out in the OC, delimitation of a specific hospitalization unit in the RC, a discharges and a pre-discharge circuit throughout the RC, written rules of coordination between the healthcare unit, the Social Work Unit and the Hospital Pharmacy Service, welcome sheet and an information circuit for primary hospitals. Results: 247 patients were transferred. No patients had to stay in the emergency area of the RC. There was no deprogramming of admissions of patients in the RC. The readmission index 30 days from discharge was 2.4%. The average stay in the recipient centre was 5.63 days. As for the standardized indices, the operational index was 0.6; the standard operational ratio, 0.6; the difference attributable to the operation, -4.0 and the impact, -706. Conclusions: The intervention in patient transfer from an emergency service of a high complexity hospital to a centre of less complexity, to avoid bringing the former to a standstill, improves the healthcare quality of the patients transferred and avoids reducing that of the recipient hospital.
    Original languageEnglish
    Pages (from-to)304-311
    JournalRevista de Calidad Asistencial
    Volume19
    Issue number5
    Publication statusPublished - 1 Jan 2004

    Keywords

    • Coordination
    • Emergency service
    • Healthcare process
    • Patient transfer

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