J Korean Acad Nurs.  2018 Oct;48(5):554-564. 10.4040/jkan.2018.48.5.554.

Development and Analysis of System Dynamics Model for Predicting on the Effect of Patient Transfer Counseling with Nurses

• Byun HM
• Yun EK

• KMID: 2424362
• DOI: http://doi.org/10.4040/jkan.2018.48.5.554

Abstract

PURPOSE
This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process.
METHODS
Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology.
RESULTS
The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period.
CONCLUSION
The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

Keyword

Patient Transfer; Referral and Consultation; Counseling; Continuity of Patient Care

MeSH Terms

Continuity of Patient Care
Counseling*
Delivery of Health Care
Electronic Health Records
Fees and Charges
Humans
Nursing
Patient Transfer*
Referral and Consultation
Seoul
Tertiary Care Centers

Figure

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  Figure 1 Management model of patients being transferred.

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  Figure 2 Basic simulation of model.

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  Figure 3 Scenario simulation: percentage of patients who are referred to a tertiary hospital.

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  Figure 4 Scenario simulation: percentage of patients who continue treatment at a tertiary hospital.

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  Figure 5 Scenario simulation: percentage of patients who are terminated treatment at a tertiary hospital.

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