A big picture for success

How access block became the catalyst for a statewide transformation of task management using Medtasker

Through a large-scale implementation of Medtasker, the Tasmanian Department of Health (DoH) connected thousands of clinicians across
the state using familiar, readily available mobile technology. In doing so, DoH enhanced communication and collaboration across the Tasmanian health service and eliminated location barriers to address its statewide access block crisis in a consistent and coordinated way.

Challenge

A steady increase in the number and complexity of emergency department (ED) presentations at each of Tasmania’s four public hospitals contributed to access block across the health service. With longer waiting times posing a greater risk of adverse patient events, the Tasmanian DoH needed a statewide solution to help improve the flow of admitted patients through their EDs and into wards.

Solution

DoH sought a proven solution to address its access block issues. Having delivered measurable efficiency improvements in ED referrals at Royal Hobart Hospital, Medtasker’s fully integrated mobile hospital task management, communication and collabration platform was the obvious choice for a statewide rollout.

Outcomes

Medtasker integrates seamlessly with existing systems and complements established processes at individual locations while supporting inter-hospital connectivity. Quick, secure tasking, communication and collaboration helps to streamline workflows and support doctors’ wellbeing. Detailed analysis of Medtasker’s rich data source supports decision-making and helps to drive process improvement at the hospital, health service and statewide levels to achieve better patient outcomes across Tasmania.

A statewide challenge

Access block

The Tasmanian DoH provides ED care to the people of Tasmania through its four major public hospitals – Royal Hobart Hospital in the state’s south and Launceston General Hospital, North West Regional Hospital and Mersey Community Hospital in the north.

The volume and complexity of ED presentations statewide has steadily increased, contributing to access block across the entire health service. Access block represents the inability to transfer patients who require inpatient admission from the ED to the ward in a timely manner. It reduces ED capacity and the ability of staff to assess and treat new presentations, leading to longer waiting times.

Statistics reported by the Australian Institute of Health and Welfare indicated that in 2018-19, 90%1 of Tasmanians requiring admission to hospital waited more than 22 hours – twice the national average.

Access block is more than an inconvenience for patients and staff.
It also presents a greater risk of adverse patient events.

90

%

of Tasmanians requiring admission to hospital waited more than 22 hours  

Inadequately linked IT systems contribute to poor patient outcomes

Outdated and siloed information technology is widely recognised as one of several factors contributing to operational inefficiencies and poor patient outcomes.

The digital medical record system used in the ED at each of the four public hospitals in Tasmania had limited integration with the system used throughout the hospital, causing staff to rely on manual look-up of time-sensitive information from pathology and imaging services. They had to scan paper-based medical records and paper-based transfer of ED notes to inpatient teams, increasing the potential for errors and delayed diagnoses and treatment. 

Limited access to real-time statistics, such as average length of stay and presentations per hour, also made it difficult to measure access block and other markers that could assist in managing and improving patient flow through the ED. 

ICT systems were disconnected, meaning information could not be exchanged in ways that would meet modern digital health needs. Improving access and patient flow across the Tasmanian health service required urgent investment in a statewide solution.

Medtasker

A proven solution 

In 2019, the Royal Hobart Hospital ED implemented Medtasker to quickly address inefficiencies contributing to its access block crisis. Encouraged by Medtasker’s positive impact at the hospital and the early benefits realised there, the Tasmanian DoH extended the rollout to the state’s three remaining acute hospitals.

Medtasker is a fully integrated mobile hospital task management, communication and collaboration platform. Hospital teams can use the secure Medtasker application, deployed on mobile phones, tablets or desktops, to perform patient-related tasks efficiently. Important information is securely delivered to the right person every time, helping to enhance patient safety and hospital efficiency.

The project team implemented Medtasker’s first high-availability solution in February 2021 in preparation for the statewide rollout. This was followed by a go-live at Launceston General Hospital in April 2021, North West Regional and Mersey Community Hospitals in June 2021, and a final phase at Launceston in August 2021. Implementation was quick, and the entire project was completed six months ahead of schedule.

Medtasker supports patient flow by enabling rapid communication referrals
between medical and nursing staff across the hospitals.*
 

*Tasmanian Department of Health, Our Healthcare Future – Immediate Actions and Consultation Paper, November 2020 

Medtasker: A single solution connecting facilities across the state

Medtasker’s modular design allows for a tailored approach to each implementation with full deployment flexibility. It caters for variations in the names and composition of teams, shift structures (start and end times), particularly after hours and referral workflows.

Differences in the size and operational complexity of the four remaining hospitals posed challenges for the statewide rollout. However, DoH leveraged Medtasker’s interoperability and configurability to integrate it with existing systems seamlessly and to complement established processes at each location while facilitating interconnectivity within the health service.

Quick, secure tasking

Improves workflow

A patient’s details and a synopsis of their condition are available to ED staff almost as soon as that patient enters the hospital through Medtasker’s integration with the patient administration system.

If admission is deemed appropriate, ED staff can use Medtasker’s real-time on-duty directory to refer the patient and all their relevant clinical information directly to the appropriate inpatient or surgical team within their hospital or to a team in another hospital using an Interhospital Task Group. This avoids the need for phone calls via switchboard, which may not promptly connect the ED with the right clinician. This real-time information is accessible to referral recipients regardless of location, eliminating an unnecessary repetition of diagnostic tests. 

Medtasker sends ED referrals using a secure and privacy-compliant closed-loop. Data is encrypted and images are not stored on any individual device. This feature helps reduce the risk associated with using unauthorised, insecure communication and photography tools for clinical messaging.

Access to valuable data drives process improvement at multiple levels

Medtasker is now a vital part of the statewide framework for addressing ED capacity issues and access block across the Tasmanian health service. Its consistent capture of accurate operational activity data supports increased transparency and invites detailed data analysis. Insights identify bottlenecks and inform business process improvements to patient flow and staffing, providing real value at the hospital, health service and statewide levels. 

Launceston General Hospital, for example, is a 350-bed facility with more than 44,000 ED presentations annually. In September 2021, one month after the final phase of its Medtasker rollout, the project team at this hospital reviewed metrics and extracted the following task-related data:

250K+

Total
tasks sent

1K+

Tasks sent each weekday

700+

Tasks sent
on weekends

11am / 3pm

Peak sending
times

20 secs

Time to log in
and select role(s)

This provided valuable insight into ED service demand and helped highlight an efficiency gain for the hospital: 250,000+ tasks sent meant 250,000 fewer calls through the switchboard.

Clinicians benefit from collaboration with colleagues and shared learnings based on data collected at different locations. Medtasker data also supports staff in reviewing clinical events, identifying at-risk patients and planning the allocation of resources. 

Flexibility and configurability enable solution customisation

As a highly configurable platform, Medtasker can be customised to work with existing hospital operations and processes. For Launceston General Hospital, the priority focus was to bridge the gap where staff used different systems to communicate about weekend handovers. 

A typical weekend scenario might involve 100 medical patients, 30 of whom would need to be seen on a Saturday and 15 on both Saturday and Sunday. At Friday handover, staff would write notes for the Saturday doctor – “These are the patients you need to see over the weekend for these issues” – and carry that around until handover the next day. The Saturday doctor would then repeat the process, adding more notes for the Sunday doctor. However, this reliance on paper-based transfer of information represented a risk to patient safety if the paper was lost.

This was resolved using Medtasker, with future tasking embedded into the existing workflow, removing paper-based handovers and the associated risk of information loss.

Transform your health service

With the completion of this rollout and strong adoption by stakeholders, Medtasker has helped connect thousands of clinical staff across the state using familiar, readily available mobile technology and, in doing so, helped introduce a new level of communication and collaboration in the Tasmanian Health Service. Staff can now move between hospitals confidently, knowing they’ll use the same system in each hospital and can refer tasks quickly and efficiently to colleagues in other locations when required. 

Health services across Australia and New Zealand still struggle with outdated communication tools, inefficient workflows and limited visibility of auditable data and analytics, with only 25% using electronic or mobile task management systems. 

Tasmania’s experience demonstrates how a large-scale, statewide implementation of the right solution can overcome location barriers to deliver measurable benefits to a health service that is under-resourced and under pressure.

“Although 90% of the required handover information was already embedded in Medtasker, it was designed for immediate ‘I need this done now’ tasking rather than in-the-future tasking. But through a process of collaboration, Medtasker was able to tailor the solution by adding a new role for future tasking to meet the specific needs of LGH. And they made that happen within weeks.”

Dr Leanda Griffin, Staff Specialist Intensivist and General Physician, Launceston General Hospital