New GP referrals cuts A & E pressure

A new direct GP referral system means family doctors may now bypass A&E when referring patients to University Hospital Galway.

GPs can now ring a specialist consultant at the hospital about patients and receive advice and support about treating them or will be advised to send the patient directly to the facility’s medical assessment unit (MAU ), bypassing the emergency department.

The service, introduced last month, has led to a 60 per cent reduction in GP referrals to the emergency department.

The purpose built 11 bay assessment unit was officially opened last June with the initial aim of fast-tracking the assessment of patients presenting with acute medical problems and to facilitate early diagnosis and initiation of appropriate treatment.

It has two single isolation bays with access for those requiring admission to a dedicated eight bed medical admissions area. Construction on the €1.9 million unit began in January 2008 and it opened to patients in June 2009. A surgical assessment unit, which will provide a similar service for surgical patients, will open in the next few weeks.

The MAU allows patients to be discharged earlier, reduces the volume of medical admissions and shortens the length of time patients spend in hospital. The direct referral service for GPs, which started on April 16, is the second phase of the development of the unit. On average only one in four patients seen there needs to be admitted to hospital.

The GP referral service is one “innovative way” identified by management and clinicians at Galway University Hospitals to reduce the need for people to attend the emergency department (ED ), according to the HSE West.

Dr Pat Nash, clinical director for medicine at GUH, says the hospitals are working to introduce a range of measures, including a reduction in the time patients spent in ED and also to avoid patients presenting at ED.

“Our goal is to ensure that seriously ill patients do not have to wait to get an inpatient bed. We have been reorganising and rearranging our services so that we can treat and assess more people outside of the ED and we are currently implementing the national discharge protocol. As healthcare providers we do not wish to have any patients waiting longer than necessary in our ED department.”

Pat Commins, acting general manager for GUH, says the new medical assessment unit enables early clinical decision-making by senior medical personnel with the aim of enhancing patient care.

“In addition the GP referral service has already reduced the number of patients who will require admission to the hospital or who have to spend time waiting for admission through the emergency department. The focus of all our efforts is improved access by patients to the acute services they require and reduce pressures in the emergency department. We want to ensure that patients will have access to the right care, at the right time, in the right place, and delivered by the right people.”

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