Technology in action

Automated referrals reduce waiting times for North Staffordshire orthopaedic service

April 2008

North Staffordshire Combined Healthcare NHS Trust is a provider of complex care services. The Health Intelligence and IT Services act as shared agencies, hosted by Combined Healthcare, providing health informatics services and support across the North Staffordshire health community. This consists of two primary care trusts and Combined Healthcare NHS Trust, while maintaining close working links with the University Hospital of North Staffordshire (acute services).

Challenge

The goal of North Staffordshire Health Intelligence Service is to improve the health and welfare of its local communities and ultimately provide the best care for its patients. One challenge the organisation faced was in the orthopaedic area where patients in need of musculoskeletal services were experiencing long waiting times in getting referred to practitioners for care.

The management of referrals is a critical process, as delays and inefficiencies can lead to patients needing secondary care or being admitted on an emergency basis. Clearly, it was necessary for North Staffordshire to control this process and ensure its patients received prompt care.

North Staffordshire had been using paper-based methods to manage patient referrals, which resulted in inconsistencies, duplication of work, and a lot of time chasing referral paperwork between practitioner practice staff and hospital staff.

In order to reduce waiting times and provide a framework for patients to be managed from primary care to specialist care and back into the community, the organisation recognised the need to process documents faster and more efficiently. It set out to find a technology to help develop a new referral pathway in addition to driving the automation of other critical processes.

Solution

North Staffordshire turned to Metastorm BPM to facilitate the development of an electronic referral and discharge system for its SMASHERS project — the Stoke Musculoskeletal Appointment Slot Hospital Early Referral System.

Using Metastorm, the organisation built an automated system that manages the terms of a primary care service for the triage, assessment and treatment of patients with musculoskeletal problems. Electronic referrals are now generated directly by the general practitioners' (GP) offices via a Metastorm BPM icon within their clinical systems.

The forms are pre-populated with patient demographics for faster entry and once complete are automatically routed to the appropriate staff member for action. As soon as an electronic referral is generated, an electronic discharge is initiated as well. This helps move patients through the system and allows GPs to deliver timely care to its patients.

The referral and discharge system is available to all GP practices in North Staffordshire and allows the organisation to manage demand by triaging patients to the most appropriate specialty and the most appropriate clinician with the shortest wait time. As more GPs use the system, it will better allow patients to be seen by the right provider, in the right place and at the right time.

North Staffordshire was so pleased with the success of its first automation project that it decided to leverage Metastorm in additional areas, including its Rapid Access Chest Pain Clinic referrals — a process comparable to its initial automation project, except with a focus on cardiac patients.

By automating this process, patients now receive care in a matter of hours. Another core process that has also been automated is its Incident Reporting process — a critical procedure that tracks any incident that occurs on the clinical or administrative side and routes the incident form to appropriate personnel for action.

The system documents and tracks explanations, for risk management and audit purposes. North Staffordshire has also automated a process known as establishment control, which is used as its electronic recruitment system for job posting authorisations.

Results

The solution is yielding excellent results for North Staffordshire as they have improved the way in which care is delivered to patients and positively impacted service delivery.

The process automation, management and control capabilities that the system provides have also improved overall process and data accuracy and empowered users with access to information to ensure that referrals are no longer lost or delayed.

The organisation now knows where all referrals exist within the process. If a process is delayed, the team has visibility into where and why. Using the old paper system, it took up to four days for a patient to receive a referral for care, and now that critical process is reduced to a matter of hours.

All processes are tracked and documented, and North Staffordshire now has visibility into historical data for reporting, analysis, and organisational improvement.

Metastorm BPM has been endorsed as a critical system and will continue to be used to automate, and control core processes. North Staffordshire now has projects in place to fully utilise the process planning and implementation capacity of the system to automate corporate documentation such as expenses, timesheets and annual leave forms.

The main benefits of this will be reducing administration overhead, reduction in paper forms used and storage costs, and faster processing of documentation, resulting in accurate and up-to-date records.