"My mother's experience transferring to a hospital closer to home."

About: Barham Koondrook Soldiers Memorial Hospital Echuca Hospital Kerang Hospital / Urgent Care Centre

(as a relative),

My parent was in Barham Hospital for continuing vomiting several hours after eating. It was found on CT scan, that my parent had a small bowel obstruction, so they were rushed to Echuca Hospital for immediate surgery. During the surgery, a temporary stoma was created as they couldn’t connect the bowel to my parent's existing stoma (from their bowel cancer a number of years earlier). The stoma was reversed a week or so later. My parent continued to be tube fed and had ups and downs with vomiting and nausea. After almost a month and a half in Echuca Hospital, my parent was anxious to get closer to home as they were feeling isolated from family and friends. We all live more than one hour from the surgical hospital my parent was admitted in Victoria. My parent requested to be transferred to Kerang, so I could help them and keep an eye on them while they finished recovering from the 2 surgeries. My parent’s weight dropped to 34kg during this time and my parent was tube fed quite a bit as well.

Echuca contacted Kerang and spoke to a senior staff member. This staff member said Kerang would be okay to have my parent as long as my parent wasn't still on the TPN (total parenteral nutrition) feed drip in their PICC (peripherally inserted central catheter) line. Echuca also rang the Kerang Medical Clinic in order to speak to one of the doctors about accepting my parent as his patient for the transfer. My parent had seen this doctor when he was working in Barham, as well as two other doctors. According to my parent and Echuca Hospital, the Kerang Medical Clinic did not return any of the ½ dozen calls made to them with regard to this.  My parent was highly stressed about this and asked Echuca to try ringing Barham Hospital instead.  Barham Hospital accepted my parent back on the spot and my parent was transferred by family back to Barham. My parent was then discharged and is now home. My parent will be getting home help, etc. for the next 4-6 weeks. 

My question is this: If Barham could accept my parent back as a patient (without consulting the doctor) why could Kerang not accept them back?  I was a little disappointed that this happened and no explanation was really given other than a comment that if my parent was only convalescent care they wouldn’t be accepted. The message was that my parent had to be medical care or surgical care. As my parent had just had 2 operations and a PICC line in for security should they start vomiting again, how is my parent not considered a medical patient? My parent was severely malnourished and needing dressings daily for the second stoma which was treated as an open wound. 

Could you please explain to myself and my family why Barham Hospital could accept my parent so readily, but Kerang (which is a bigger hospital with more facilities and more doctors visiting) could not?

Responses

Response from Chloe Keogh, Director of Clinical Services, Kerang District Health We are preparing to make a change

picture of Chloe Keogh

Dear Patient Daughter

Thank you for your posting. I am very grateful to you for taking the time to feed back your parent's experience. It sounds like your family had a long and stressful journey in the health care system and I feel disappointed that here at Kerang District Health we were not able to support your parent better in this journey.

I would like to talk to you more about this situation, and invite you to call me on 03 54509210, or email ckeogh@kerhosp.vic.gov.au

Due to Doctor shortages in our town currently the Kerang Medical Clinic Doctors are so heavily booked that they cannot accept new patients into their clinic, as they cannot cope with the current demand. I feel disappointed that this was not clearly communicated to the clinician who had called from Echuca Regional Health, as it could have made your parent's journey easier, and lessened the frustrations felt.

I am going to look at ways that we can communicate our message clearly and support patients who need care and convalescence closer to home.

I hope that your parent is recovering well now, and I will be back in touch within a week, regarding how we are looking to improve this process with the situation and workforce that we have.

Kind regards,

Chloe Keogh

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Response from Robert Jarman, CEO, Kerang District Health

picture of Robert Jarman

Dear Patient Daughter

Although Kerang District Health may not have been able to assist you on this occasion, your feedback is important to us.

As indicated by Chloe Keogh our Director of Clinical Services it seems some valuable time was lost initially due to the unavailability of our local GP's in Kerang who work as Visiting Medical Officers and admit patients to hospital.

It is pleasing that two new GP's have been recruited to Kerang in the last week and will commence in September.

Regards

Robert Jarman

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Response from Chloe Keogh, Director of Clinical Services, Kerang District Health We have made a change

picture of Chloe Keogh

Dear Patient Daughter

I have been talking to the admitting Doctors, the clinic staff, and ward staff about how to improve our system in accepting patients back from other hospitals to Kerang District Health, and to make it an easier process for the patients, so that they can receive care as close to home as possible. We believe we have come up with an easier process. This cannot undo the issue that your parent experienced, however hopefully we can stop other people experiencing the same degree of frustration.

In the process we have redesigned, a transferring hospital rings the Nurse in Charge at the Kerang ward, and they will then arrange the accepting local Doctor, and the bed availability, and confirm the transfer can occur by return phone call, within a time frame. So, for your parent, the care could still have been delivered at Kerang District Health, and closer to their home, and where you preferred, without all the stress and worry, and the missed phone calls.

I would love to hear if you think this would have been better for your parent, or if you think there is something that I may have missed in this change process that might make it even better.

Kind regards,

Chloe

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