How patient flow helps support integrated healthcare services

What happens when patient flow is used to support integrated healthcare services? In Derbyshire, ExtraMed reaches beyond hospital walls and the same system is used by GP Care Coordinators. What does it mean for admissions, discharges, patient experience and joined-up care?

We recently spoke to Alison Goodrum (Care Coordinator at the Jessop Medical Practice in Ripley), Micheala Kirkman (Care Coordinator, Ivy Grove Surgery, Ripley) and Trudi Jones (IT Project Manager, Royal Derby Hospital). They shared their experiences of how access to patient flow helps them do their jobs.

A well-liked system that needed to be shared

Derby Hospitals NHS Trust implemented ExtraMed to support bed management and help address the challenges of winter pressures. The system was quickly adopted and became a valuable asset. A range of teams adopted ExtraMed, its use evolving to include everything from allied healthcare services to coordinating the discharge process across health and social care.

It was decided that the next step would be to extend its reach into community services. By the end of 2018, there were 8000 users in the Trust and over 800 users in the community such as GPs and practice staff, therapists, care coordinators, community matrons, district nurses, community therapy teams, social services personnel, carers associations and SPA (Single Point of Access) teams.

Enhancing patient care in the community

Integrated healthcare services offer quicker discharges and help to ensure the right aftercare is in place at the right time. It can also contribute to patient safety and reduce readmission to hospital.

“Sometimes we know information from the community that the hospitals don’t recognise or don’t know about,” says Alison Goodrum. “Having the option of being able to put a little note on the system is brilliant because then at least both parties know what’s happening at home. Then the hospital picks that up and hopefully identify it as a need.”

“Sometimes it’s just some very minor change that’s needed that might prevent another hospital admission,” added Micheala Kirkman.

Where previously care coordinators may have spoken to three or four different individuals on the phone in their quest to find the right person, they can now easily see the right contact on-screen, saving precious time and effort. In fact, care coordinators estimate they’re making around 90% fewer phone calls.

District nurses within the ICS team use the system daily to save them from wasted home visits, first checking to see if the patient is in hospital. Where patients are in and out of hospital frequently the system provides care coordinators visibility of that fact so individuals can be highlighted and investigations initiated. Simple measures, like befriending, could be enough to break the readmissions cycle.

The benefits of patient flow for integrated healthcare services

• Provides high visibility for a complete picture
• Ensures the right care at the right time
• Saves time by reducing calls and wasted visits
• Reduces readmission by improving patient experience and staff responsiveness

Offering real, joined-up care, particularly post-discharge, integrating patient flow into the community network ensures a better experience for everyone. As Alison concluded: “any hospital and their community services would benefit from using the ExtraMed system.