Tan Tock Seng Hospital Emergency Department Right Siting to General Practices: GPNext
Care Continuum
Care Process & Redesign
National Healthcare Group Quality Improvement
National Healthcare Group
31 December 2019
To reduce unnecessary referrals from the ED to Specialist Outpatient Clinics (SOCs) by right-siting stable ambulatory. GPNext reduced wastage, improved resource utilization, and provided affordable, timely care for stable ED patients.
Year Submitted: 2019
Published Date: 31 December 2019
Tags: Care Process ＆ Redesign, Care Continuum, Access To Care, Referral Rate, Intermediate and Long Term Care ＆ Community Care, Right-Siting, Acute Care, Ambulatory Care (Outpatient Care)
About this Content
Aims
To reduce unnecessary referrals from the ED to Specialist Outpatient Clinics (SOCs) by right-siting stable ambulatory patients to Primary Care Physicians (PCPs).
Background
High no-show rates (50%) for SOC appointments from ED referrals led to wasted hospital resources and longer SOC wait times. Many patients with minor conditions could be managed by GPs.
Methods
Implemented GPNext for 5 departments (Urology, General Surgery, Orthopaedics, General Medicine, Respiratory Medicine). Developed clinical decision guides, pathways, and communication support for GPs. Conducted GP engagement and education.
Results
Reduced unnecessary SOC referrals. 176 ED patients were discharged to GPs, achieving cost savings of $33,712 annually. GPNext demonstrated safety and efficacy with no clinical deterioration in patients.
Conclusion
GPNext reduced wastage, improved resource utilization, and provided affordable, timely care for stable ED patients.
Lessons Learnt
Sustainability achieved by leveraging existing resources and CHAS subsidies. Trust and communication with GPs are critical. A safety net ensured patients could escalate to SOCs if needed.
Additional Information
Recognized by Ministry of Health and scaled under ‘Outpatient to Community’ program in 2020.
Keywords
Care Redesign, Right Siting, Acute Care, Cost Savings, Continuity of Care, GP Collaboration, Primary Care, Emergency Medicine
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | National Healthcare Group Quality Improvement |
Healthcare Professional Group(s) | Ancillary Care, Medical |
Applicable Specialty or Discipline | Emergency Medicine, General Practice |
Project Lead(s) | David Foo Chee Guan, Ang Hou, Evelyn Tan |
Project Member(s) | Sharon Yeo |
Connect with this contributor!
Evelyn Tan Si Miao - Evelyn_SM_Tan@ttsh.com.sg
A/Prof David Foo - David_Foo@ttsh.com.sg
Project Attachment
350_TTSH_NHG_QI_Award_2019_TTSH_ED_Right_Siting_to_General_Practices_GPNext_combine.pdf