Arranging an Admission Bed for a PERS Transfer
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Purpose
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To communication and organise with appropriate hospital personnel an admission bed for a pregnant woman in need of emergency transfer from another hospital.
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Definition of terms
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MHW - Mercy Hospital for Women
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MMC - Monash Medical Centre
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RWH - Royal Women's Hospital
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Process
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When transfer to a tertiary maternity service has been agreed as necessary and appropriate, the PERS Obstetrician or Co-ordinaor should ask the referring healthcare professional if s/he has a preference for receiving hospital if more than one unit is open. The PERS Obstetrician or Co-ordinator then contacts the nominated bed manager of the relevant hospital (MHW/RWH/MMC contact details below) to confirm bed availability. In the event of a bed state restriction at that nominated hospital the other two hospital bed managers should be contacted. If unable to organise a bed at this level, the on-call PERS consultant is to further negotiate a bed with an apporpriate representative of the three tertiary maternity units, using PERS teleconference rooms (see levels of consultation below). The on-call PERS consultant will then inform the co-ordination centre of the identity of the receiving unit.
When transfer to the maternity service of MHW/RWH.MMC has been decided upon the transfer of clinical information should be facilitated by linking the referring healthcare professional to the receiving Obstetric Registrar; in some circumstances the PERS consultant may choose to directly liaise with the receiving consultant on-call.
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Contact points for bed finding:
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Two levels of decision-making have been defined by each of the tertiary maternity unit regarding bed availability:
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- First level: All initial bed-finding communications should be at this level
MHW - Maternity Nursing Supervisor (03) 8458 4126 or page via switchboard (03) 8458 4444
MMC: Obstetric Registrar in Delivery Suites (03) 9594 6666 pager 258
RWH: Monday - Friday 0730-1500 Bed Manager; otherwise After Hours Manager: Page via switchboard (03) 9344 2000 (internal 92).
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- Second level: Communications are to be escalated to this level by the PERS consultant if agreement cannot be reached by the individuals at level one due to maternity bed non-availability.
MHW: Director of Obstetrics (or representative); Page via switchboard (03) 8458 4444
MMC: Obstetrician on-call.Women's & Children's Nurse Director; page via switchboard (03) 9594 6666.
RWH: Director of Obstetrics (or representative); page via switchboard (03) 9344 2000 (internal 92).
If consultation at this second level is not able to secure an appropriate bed due to maternal bed non-availability, each of the second level contacts will advise their hospital CEO. If the 3 CEO's have personally assessed the situation and agree that they are unable to arrange a clinically necessary transfer one of the CEOs, on behalf of the three CEOs should then contact the Executive Director of Metropolitan Health and Aged care Services (currently Lance Wallace).
In the event that neonatal capacity is the issue which is preventing appropriate maternal transfer the PERS consultant should discuss the case with the NETS consultant on-call. the Department of Human Services 'Neonatal Intensive Care Unit Critical Capacity Guidelines' then provide guidance for management.
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*Mildura is to be assessed separately as it is often more appropriate for a maternal transfer to be negotiated with Adelaide; such a transfer does not need notification to/discussion with the Department of Human Services unless the family are not happy with such a transfer destination.
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Time Critical Transfers
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The process for time critical transfers:
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- PERS consultant to identify if the transfer is time critical (scale being developed using NETS guidelines)
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- PERS consultant makes the decision which hospital the woman is being transferred to based on proximity to the referring hospital as per above contact points for bed finding - and notifying them of the imminent transfer and need for a bed.
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- If there appears to be no bed availability within the required timelines, the Co-ordinator to link the second level hospital contact with PERS consultant to discuss the logistics of the transfer.
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