Royal Melbourne Hospital: Improving access to specialty referral services at RMH: A review of the inter hospital transfer process (2022-23)

Improving access to specialty referral services at RMH: A review of the inter hospital transfer process (2022-23)

Description of the project:

The RMH is a major metropolitan health service that provides specialty tertiary/ quaternary and state-wide services. We receive referrals for our services from multiple metro and rural/regional services. This process is managed by the accepting clinical units in conjunction with the access and patient flow team (bed management).
RMH provides clinical services to these patients and then aims to transfer the patients back to their referring centres so they are able to receive ongoing care closer to home.

RMH is keen to understand if we could improve this process in order to improve efficiencies and improve access to specialist care. Therefore, using an improvement science approach, this project aims to better understand our process by completing a process map and data analysis regarding our current transfers. Furthermore, the project will assess the viability of web based tools that can be used to manage the transfer process and make recommendations for any improvements. The project will include consultation with key stakeholders (clinical and management).

The expected outcomes are highlighted below.

Completion of a process map outlining the current process for the end-to-end journey of patients referred from metro and rural/regional health services to RMH.

Data analysis of historical transfers in and out of RMH (including demographics, reason for referral, length of stay, specialty unit referred to, cancelled transfers).

Review current web based tool used to manage inter hospital transfers in and out of RMH.

Assess the suitability of utilising the RMH Electronic Medical Record (EMR) as an alternative system for managing inter-hospital transfers.

Recommendations for potential improved process efficiencies, including a revised process map.

Recommendations regarding communication processes with referring centres, including the use of telehealth specialist appointments to avoid unnecessary transfers.

The RMH is one of the largest health providers in the state of Victoria, providing a comprehensive range of specialist medical, surgical, and mental health services; as well as rehabilitation, aged care, outpatient and community programs.
Our care extends from the City through Royal Park and 32 mental health services across the north-western suburbs of Melbourne. We are a designated statewide provider for services including trauma, and we lead centres of excellence for tertiary services in several key specialties including neurosciences, nephrology, oncology, cardiology and virtual health.
We are surrounded by a precinct of brilliant thinkers, and we’re constantly collaborating to set new benchmarks in health excellence – benchmarks that impact across the globe. This includes the world-renowned Peter Doherty Institute for Infection and Immunity, our joint venture with the University of Melbourne.
And while the work we’re doing takes us in inspiring new directions, we lead with kindness that defines a better standard of care.
Our people of more than 11,000 strong, embody who we are and what we stand for. Our reputation for caring for all Melburnians is as essential to who we are as any scientific breakthrough we make. We’re here when it matters most, and we’ll continue to be the first to speak out for our diverse community’s wellbeing.