Excellence in Patient Care Closing the gap - Integrating health care to improve patient outcomes

Hato Hone St John

Team: Lianne Pepperell, Olesya Zaglyadimova

Hato Hone St John has seen an increase in complex need cases, including frequent callers, patients across the continuum of mental health and mental illness, and vulnerable people experiencing domestic abuse, neglect and social vulnerability.

Due to the sensitive nature of these cases, types of referrals required, and increased documentation (including outcomes and community care notes), it became apparent that our previous patient report and referral approach was not fit-for-purpose. Having the ability to clearly document the care provided and interventions completed, not only gives the ability to recognise patterns in calls, but also identifies failed referral outcomes, frequent abuse referrals and gives a clear history.

For the twelve-month period of January 2022 to January 2023 there were 6,176 referrals generated by our road ambulance personnel, including 813 vulnerable persons referrals (or approximately 68 cases per month). Within the New Zealand health context, vulnerable persons referrals for patients aged between 18 and 65 are managed in primary care, therefore 34% of referrals were being made to General Practice, with no robust way for Hato Hone St John to share information with GPs.

In 2022, Hato Hone St John introduced My Practice to manage patient information and document clinical notes, augmenting existing patient reporting. The tool introduces the ability to refer to external providers and share critical information with existing healthcare providers.

Since the implementation of My Practice in July 2022 we have been able to provide secure messaging to and from GPs and allied health providers. The tool has enabled communication between the ambulance service and primary healthcare services. My Practice has been pivotal in allowing the addition and review of patient clinical notes for our vulnerable person’s referrals.

The benefits include:

• Seamless transition of care between providers.

• Alignment of data sharing practice to other providers of allied health.

• Record of referrals and interventions against a patient’s National Health Index number (NHI).

• Secure messaging to and from providers ensuring patient privacy.

• Secure clinical notes for every interaction.

• Ability to see previous interactions and any alerts.