Galway University Hospitals has successfully piloted an Emergency Department avoidance programme, which has the potential to significantly reduce ED attendances and save hospital bed days.
The programme sees GPs refer patients to a virtual navigational hub which in turn streams them to the most appropriate care pathways.
The key goal of the acute navigation hub is to decrease the number of GP-referred ED presentations by 10 per cent and navigate patients away from ED, where appropriate, to alternate urgent care pathways. These include direct referrals into acute services in the hospital or to urgent out-patient appointments in hospital clinics or community specialist hubs.
The Acute Integrated Pre-admission Navigational Hub was established as a pilot programme, operating on a restricted basis Monday to Friday from 9am to 1pm.
A total of 13 GP practices with 48 GPs were involved in the pilot including one practice located on Inishturk Island.
Over a five month period the hub has dealt with 108 referrals, with two thirds of these patients avoiding an ED visit as a result. Some 59 patients were diverted to new or existing pathways. Within one week of receiving the referral in the navigational hub 78 per cent of patients were seen by the appropriate specialist.
For patients aged 75 or older, 35 were referred to the hub and 28 (80 per cent ) avoided ED attendances as a result.
The pilot has resulted in an estimated 156 saved bed days, freeing up these beds for other patients.
“This pilot programme has proved hugely successful and has had a real and positive impact for our patients," said Dr Yvonne Smyth, consultant cardiologist at GUH and chair of the pilot programme. "This pilot brings together medical services across our hospitals, GPs and community services and has created a clinically safe service that is sustainable.”
Dr John Lally, a Galway GP who took part in the programme, added: “This integrated pathway allows us to work together to treat our patients in the setting most appropriate for their needs, within a reasonable timeframe. The successful pilot shows the importance of more pathways such as this.”
Nationally ED attendances have increased by 7.7 per cent compared to 2019. This demand is predicted to continue, requiring a change in demand management. Figures for 2023 showed a 7.3 per cent increase in ED attendances in GUH, with 31,000 of these recorded as GP referrals.
Chris Kane, hospital manager for Galway University Hospitals stated: “This virtual navigational hub is supporting our aim to achieve the goal of 'right person, right place, right time, first time’ and to direct patients to the appropriate pathways.”
