Consulting on interaction in acute patient pathways – Hadsel municipality etc.

Hovedtrekk ved prosedyren

The establishment of an interaction post in Vesterålen, as a joint initiative between theNordland Hospital Vesterålen and Sortland, Hadsel, Bø, Øksnes and Andøy municipalities, represents a strategic response to the escalating demographic challenges in the region. The initiative shall contribute to more coherent, efficient and sustainable patient pathways, in particular advanced patients with compound and unresolved conditions.1. Purpose descriptionHadsel municipality, in cooperation with other municipalities in Vesterålen and Nordlandssykehuset Vesterålen, is facing increasing challenges connected to handling emergency patients. This particularly applies to elderly patients with complex, compound and unresolved medical conditions. The patients often move between municipal services, the emergency doctor surgery and hospitals, without the patient pathways being sufficiently coordinated or clarified. The objective of the procurement is to obtain external consultancy competence that can support the contracting authority for the work of reviewing, assessing and recommending a uniform and sustainable model for interaction in acute patient pathways, in accordance with the principle of best effective care level (BEON). The aim is to establish clearer patient pathways, clearer responsibilities and better interaction between the municipal health service and the specialist health service. The challenges in the current service organisation: The current organisation of the services is characterised by a clear structural and organisational distinction between the primary and specialist health services. This contributes to fragmented patient pathways, unclear responsibilities and missing solutions in the middle area between municipal emergency services and hospital admission. The consequences of this are that patients are either hospitalised without a clear need for specialist treatment, or held back in municipal services without sufficient medical clarification. In both cases, the risk for delayed treatment, function falls, receptions and reduced patient safety increase. The data basis from the region shows that a significant number of medical patients at NordlandSsykehuset Vesterålen are issued within 0-1 day. This indicates a significant improvement potential in the patient flow and supports the need for better systems in the transitions between municipal services and hospitals. Inspections, internal assessments and professional analyses at the same time point to systematic weaknesses in the emergency medical chain, including triage, responsibility claims, information flow, ICT support and interaction across service levels. The current practice also has considerable capacity and cost consequences. Short and frequent hospital stays bind up resources in the specialist health service, at the same time that the municipalities are incurred increased costs connected to emergency reception, follow-up and admissions. The lack of general financing and interaction models increases the risk of overthrowing costs between management levels, rather than efficient use of resources and treatment at the right level. The region is also characterised by persistent recruitment challenges within health personnel. Small and fragmented professional environments, high work pressure and limited development possibilities reinforce the challenges of recruiting and retaining qualified personnel, and emphasise the need for more robust and attractive professional environments as well as new forms of cooperation.2. Description of requirementsFor meeting the challenges described above, the contracting authority needs external consultancy services that can supplement the project organisation ́s work. The project organisation is responsible for local anchoring, internal communication, dialogue with its own managers and decision makers, as well as ownership of further implementation and operation. The consultancy assistance shall primarily contribute with analysis, structuring and professional assessments and support the project with a uniform and applicable decision basis. Phase 1 - Review and recommendation of interaction model claims mainly of consultancy services connected to analyses and structuring of decision basis for interaction around emergency patients. The role includes professional and process facilitated interaction between involved actors, assessment of alternative models for interaction and organisation, as well as legal and economic assessments and quality assurance. Furthermore, a description and analysis of complex interfaces, responsibilities and dependencies between the municipal health service and the specialist health service will also be included. Phase 2 (option): Implementation of the recommended model: If the option is triggered, the delivery shall include assistance with the establishment, introduction and transition to ordinary operation of the recommended interaction model.