Instead of a prescriptive transfer format, formal partnerships were established with outlying community hospitals in which training, residency, corporate brands, policy, and equipment needs are established and shared. When a community hospital wants to establish a partnership, personnel from Sick Kids goes and inspects the hospital using the ACEP Guidelines for Community/Tertiary care centers. Once the hospital meets these requirements a partnership is set up. After this point, the community hospital agrees to accept all Level one and two patients from their area and Sick Kids accepts all Level 3 patients (based on physician assessment) patients without question. Also, Sick Kids commits to provide training for 30 of 52 weeks of the year for the community hospital’s staff, residents rotate through the community hospital, open education sessions are offered for the physicians, there are cross appointed physicians for both sites.
Once decisions are made to transfer patients from Sick Kids to a community hospital, a follow-up phone call happens within a week to assess family satisfaction.
Emphasis is that the decision to repopulate/transfer is a medical decision NOT the family’s decision. It is reinforced that the child, while needing admission doesn’t need the specialized care at Sick Kids, that Sick Kids endorses the level of care provided at the other hospital. Equally important is the public awareness campaigns. Ads are run in newspapers, radio and television. It is made clear that families/parents are not to be made to felt that they have to triage, they are to go to their closest hospital where care will be provided (rather than travelling to the Sick Kids). This represents a culture change in the community hospitals and Sick Kids.
There are several key messages inherent in this collaborative model. The first is that hospitals are not fighting over business; instead rather there is an improvement in patient care when collaborations exist. Also, community hospitals in fact provide better care for Level 1 and 2 patients in the same way that Sick Kids provides better tertiary care so both centers can capitalize on their own experiences. Finally, the message is clear that each hospital (whether tertiary care or a community center) are doing a different line of work, and are not in fact competing.
This collaborative model resulted in several new mandates at Sick Kids. The first is a mandate to transfer knowledge between collaborative centers. The second mandate, which states that centers can learn from each other, comes directly from the first. The final mandate developed from this new collaborative model is to provide better care for kids closer to home. As a result of this new model, partnerships/joint