One single coordination point for transferred hospital care in UMC Utrecht

The Bureau Zorgbemiddeling (Healthcare Mediation Agency) at UMC Utrecht (BZU) has made huge strides in the past six years with the regional and supra-regional coordination of specialist (pharmaceutical) care at home. With the growing development of the healthcare network and transferred hospital care (ZVZ), this work has become increasingly important. In a conversation with Wilma Bijsterbosch programme manager ZVZ/manager BZU and Renske van Kortenhof, paediatric/transfer nurse at the Bureau Zorgbemiddeling at UMC, we discuss the developments they have implemented and the success factors.

Transfer agency

The transfer process within UMC Utrecht has been optimised in recent years. Everything goes through a professional transfer agency to ensure proper coordination with the NC&H (nursing homes, care homes and home care), with a key focus on continuity and quality of care in the chain. This has proven successful, as most of the digital transfers from UMC Utrecht receive a positive evaluation. If there are any questions, the transfer agency can easily be contacted.

Ongoing collaboration

While the transfer agency serves as the essential link for healthcare coordination and coordination with NC&H, in the past six years it has also played a role in ongoing cooperation after a transfer. In some care programmes, care continues outside the hospital under the hospital’s responsibility. In these cases, there is a need to digitally organise, coordinate and align this care. This used to involve a lot of phone calls, but now people can collaborate efficiently in Enovation POINT using the ‘continuous file’.

Processes and protocols

A great example cited by Wilma concerns a specific care programme: the administration of immunoglobulin in patients with muscular diseases or an immune disorder. UMCU is one of the specialist centres in the Netherlands for this care, treating over 500 patients at home each year. These patients receive their medication at home from home care technology nurses every three weeks, for many years on average. Coordination and clear agreements with NC&H are crucial here. However, several UMC Utrecht specialist treatment teams are involved, each of which had their own protocols.

To organise this effectively in the healthcare network, UMCU first standardised its internal processes: by bringing all the involved specialisms together, they reduced eight different protocols down to one. The coordination for this group of patients now runs through Wilma and Renske’s BZU and NC&H have a single point of contact.

“The most important lesson here is to organise your own processes first, align them with the healthcare network and then look at the existing technology.”

Reusing existing solutions

This organisational step was necessary to set up cooperation within the healthcare network. All process support, information exchange and communication with the healthcare network runs through Enovation POINT, which in the end was the easiest part to organise. Once again, the most important lesson here is to organise your own processes first, align them with the healthcare network, and then look at the existing technology. Reusing existing solutions instead of reinventing the wheel often solves the problem.

The use of Enovation POINT means that the hospital can easily stay in touch with the various home care organisations throughout the country by using the ‘continuous file’. Information is shared via the chat and upload function (photo/files). In this information exchange, the Bureau Zorgbemiddeling plays a coordinating and supportive role for patients, practitioners and home care technology nurses.

Transferred hospital care

Within UMC Utrecht, the transfer agency is a crucial part of the Bureau Zorgbemiddeling, as are the Medical Direction Centre (home monitoring), the WSD team (wound-stoma-decubitus) and the back office for ZVZ aids, to effectively support transferred hospital care. Although the immunoglobulin example concerns a specific small group of patients, there are an increasing number of care processes being offered at home. Similar to the immunoglobulin administration, POINT is also used for (paediatric) oncology, intravenous antibiotics or other infusion therapy. But the success of remote care hinges on good organisation and coordination, supported by ICT applications.

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