SCHN is implementing workflows which will allow for 2 simultaneous Inpatient encounters to facilitate patient care during transfers for Day Procedures. This workflow is applicable for all SCHN inpatient units for example, Bear Cottage patients transferred to SCH for Oncology care, or patients transferred between sites for Diagnostic tests under general anaesthesia.
Advantages of this workflow:
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Assist in medication management – medications will no longer be required to be cancelled and re-ordered at each transfer.
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Improves accuracy of length of stay data.
Summary of the 2 simultaneous Inpatient encounter workflow:
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If an inpatient needs to be transferred from the original facility, Facility 1, to a second SCHN Facility for a daily procedure / investigation, a second inpatient encounter can be created at Facility 2 without discharging the encounter at Facility 1
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The encounter at Facility 1 must be modified to have Collaborative Care Status as PART Care from Another Public Facility
- The encounter at Facility 1 must be placed on Leave with a Leave Reason of Collaborative care leave.
- The patient is then admitted to Facility 2 with the same Collaborative Care Status as Part Care Provided for a Public Facility
- Once inpatient encounter at Facility 2 is discharged, the inpatient encounter at Facility 1 must be returned from Leave
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A Duplicate Encounters across SCHN Worklist is available in Access Management Office to monitor patients with encounters at both facilities. This list will be monitored by Patient Admin Teams at both sites and if any clean-up is required it will be actioned by each team respectively.
Steps to perform this:
- A patient is identified as needing inpatient care at Facility 2 whilst still an inpatient at Facility 1 (i.e. Bear Cottage patient going to SCH for a daily scan/treatment)
- If this is known at the time of admission (i.e. to Bear Cottage) within Admission Conversation select PART Care from another Public Facility within the Collaborative Care Status field and Sydney Children’s Hospital within Collaborative Care Facility field
- If this is known after the admission is complete, use Modify Encounter conversation to update Collaborative Care Status and Collaborative Care Facility as above
- Once patient is ready to go, put patient on Leave in Facility 1 and ensure Leave Reason is set as Collaborative Care Leave (NOTE: second inpatient encounter at Facility 2 will not be allowed if Leave Reason is Gate Leave)
- Proceed with Admission of 2nd inpatient encounter at Facility 2 (i.e. SCH Randwick admission)
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On creation of Facility 2 inpatient encounter, ensure Collaborative Care Status & Collaborative Care Facility (i.e. in this scenario collaboarative care facility is now CHW) is completed as per Step 1 above.
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Once procedure / treatment is completed at Facility 2 – Discharge is to be performed from Facility 2 and patient to be returned from Leave once they arrive at Facility 1.
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Patients with two simultaneous inpatient encounters will be flagged on a PM Worklist called Duplicate Encounters across SCHN
NOTE:
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If there is an adverse event and the patient that has already been admitted to Facility 2 will not return to Facility 1, but stay at Facility 2, this is no longer Collaborative Care:
- In Facility 1, Cancel the Collaborative Care Leave and note down Leave Return Date/Time
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In Facility 1 update Collaborative Care Status to be No Collaborative Care,
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Discharge the encounter from Facility 1 (backdate Discharge Date/Time to the date/time of Leave noted above)
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In Facility 2 modify the admission and update Collaborative Care Status to be No Collaborative Care and select the appropriate Care Type
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Medications from Facility 1 encounter are to be re-ordered on Facility 2.
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If there is a delay and suggestion to transport the patient back in the morning, ie Facility 2 encounter goes past midnight (for ‘administrative’ / transport reasons):
- In facility 2, retain the encounter and keep on Collaborative Care, and the medication orders, as it is a patient safety issue to have the medications cancelled.
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There is still a requirement to clean this up and transfer the patient back to Facility 1 within 24 hours and update both records accordingly.
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If the patient does not return to Facility 1 as part of the current admission (for example they are discharged home or home to a Private Facility), Collaborative Care cannot be applied. Patient is to be discharged from Facility 1, admitted to Facility 2, and discharged from Facility 2 as required.