Process improvements and time savings

Closeup of doctor looking at xrays and CAT scan on digital tablet.

The respiratory team at the Royal Oldham Hospital wanted to improve the referral process and response time for inpatient referrals. At the time, the process was manual and paper based. Therefore, this required administrative staff to manage incoming referrals and distribute them to clinicians in hard copy. There was also no adequate method to manage referrals electronically or to ensure that all referrals were dealt with in a suitable timeframe.

The challenge: referral methods

There were multiple referral methods, such as telephone calls and electronic forms, being used by different teams for inpatient respiratory referrals.

As a result, administrative staff had to manually collect referrals, gather missing or additional information. They then had to distribute them in hard copy format to the clinical team.

Therefore, adding time and process steps, resulting in referral delays and an increased risk of referrals being easily lost or overlooked.

The solution: Bleepa

Bleepa was introduced as a pilot to manage inpatient referrals to the respiratory team in December 2019.

The initial pilot was evaluated in January 2020, leading to further development and expansion of the pilot to include referrals from the Acute Medical Unit (AMU).

Then in March 2020, the pilot was paused due to the coronavirus pandemic. However, Bleepa was identified and reintroduced as a tool to support the tracking of known and suspected COVID-19 patients.

By June 2020, as the number of COVID inpatients began to decline, the team was keen to explore how the additional functionality implemented as part of the COVID pathway, with all the lessons learned, could be applied to the original proof of concept. The goal was to demonstrate how Bleepa enables clinicians to remotely view and discuss clinical grade patient images directly from the hospital’s PACS. At the same time as incorporating referral workflow into Bleepa, streamlining the referral process and generating clinical efficiencies.

Bleepa has been extremely helpful in order to manage referrals. Not only does Bleepa make things easier, it also brings about good accountability and handover between registrars and consultants. There is also scope for evidence of patients seen as well.”
– Dr Kuzhiyanjal Anish Kuriakose, Specialist Doctor Gastroenterology
What Bleepa has hopefully taken away is the ‘dreaded’ bleep, and some of the other methods of referrals as well, so that we have one unified referral method.”
– Dr Huw Pursell, Gastroenterology Registrar
Importantly, I expect Bleepa to help us improve staff experience of clinical IT systems and patient referral outcomes. Changing workflow processes will give confidence to referring teams and allow specialty clinicians to work more efficiently - for instance avoiding being continuously bleeped and interrupted throughout the day.”
– Dr Georges Ng Man Kwong, Chief Clinical Information Officer and Respiratory Consultant


The implementation of Bleepa has streamlined the respiratory referral workflow by ensuring a single point of access for inpatient specialist referrals. In addition, the use of Bleepa has standardised the referral process to include greater clinical detail, informing clinical decision making and collaboration.

In real-time, clinical teams can view their inpatient referral pipeline, triage, communicate about and action referrals from all sources using Bleepa. Furthermore, the status of referrals can be more closely monitored by all clinicians involved in the case. Therefore, reducing the likelihood of a referral being overlooked.

By implementing an electronic means of referral, the need for administrative staff to manually process referrals has been removed, freeing them up to do other tasks.

Key facts

Reduction in administrative support

One hundred percent of all inpatient respiratory referrals can be managed without admin support freeing time to focus on other tasks.

Response times

Benchmarking for respiratory inpatient referrals showed that the existing process took on average 2.1 days before the receiving team got to review the referrals.

With the introduction of Bleepa and the removal of the manual administrative steps, referrals are actioned within 0.4 days. This represents a saving of 1.7 days per referral.

Releasing time to care

A benchmarking audit shows that the process of responding to referrers can take on average 7.5 minutes per referral. The introduction of Bleepa reduces this response time to less than one minute by enabling a receiving doctor to respond using the chat in Bleepa. This results in a clinical time saving of approximately 6.5 minutes per referral.

This equates to 5.6 weeks of a full-time clinician’s time released per annum based on current usage and a prediction of 36.3 weeks of clinical time per annum released if the project is expanded to all other medical teams.


Figures based on benefits realisation analysis undertaken by Royal Oldham Hospital.