With increasing demand for healthcare services and daily overcrowding in Emergency Departments, there is a continuous drive to reduce patient length of stay in hospital in order to free up beds for those waiting for them.

In an effort to keep the length of stay reduced, when patients require admission to the hospital, they are admitted under whichever specialty medical team is “on call” during their arrival, regardless of the patient’s specific needs.

The team then requests a consultation from the relevant specialty - for example Neurology, Cardiology, General Surgery - to advise on care and, in some cases, take over care of the patient.

This scattered process actually increases length of stay, delays care and results in a situation where the primary consultant for many patients is not the most appropriate one to treat their condition.

This commonplace hospital practice of
“on call”, which had been in place for decades at the Mater hospital, was reconsidered and fundamentally transformed.

The intervention changed the practice to a daily, hospital wide takeover of care process. A structured, formal “General Internal Medicine” meeting now takes place each morning, where the “on call” physician consults with colleagues in each medical specialty to hand over care to the appropriate medical team.

As a result, patients admitted via the Emergency Department are now transferred quicker to the most appropriate speciality for their primary diagnosis. This has resulted in a reduction in the length of stay for patients for all medical specialties of between 2-5 days and up to 40% improvement in patients being attended to by the most appropriate specialty.