Galway University Hospitals pilot successful Emergency Department avoidance programme

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% 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 to1pm. 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. 59 patients were diverted to new or existing pathways.

Within one week of receiving the referral in the Navigational Hub 78pc of patients were seen by the appropriate specialist. For patients aged 75 or older, 35 were referred to the hub and 28 (80pc) avoided ED attendances as a result.

The pilot has resulted in an estimated 156 saved bed days, freeing up these beds for other patients. Dr Yvonne Smyth, Consultant Cardiologist at GUH and chair of the pilot programme praised the Hub and said: "This pilot programme has demonstrated significant success and effectively validated the concept of a virtual navigation hub. GPs can ensure that their patients are directed to the most suitable area, either within the Acute Floor, avail of the diverse range of services now available in the community hubs or rapid access to outpatient care when appropriate thereby minimising unnecessary visits to the ED. We have 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 7.7pc compared to 2019. This demand is predicted to continue requiring a change in demand management. Figures for 2023 showed a 7.3% 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.”