A look at: Y Access

No patients actually visit Yale New Haven Hospital's Y Access, yet the service has helped save many lives.

Y Access is a transfer center that allows physicians from other facilities to speak with YNHH physicians and transfer their patients to the hospital. Volume grew from 2,996 transfers in 2010, when Y Access began, to 5,878 in 2014. As of July 31 this year, 5,288 patients have been transferred via Y Access.

One reason the service is successful is that it's easy to use, said Piper Brien, RN, clinical supervisor, Bed Management. The referring physician makes just one phone call to the 24/7 Y Access Line and speaks to one of 10 transfer facilitators, all paramedics.

"It's important to have experienced medical professionals answering the line," Brien said. "These facilitators also know Yale New Haven's clinical services and physicians well and can quickly connect the referring physician to the appropriate physician here."

While the referring and YNHH physicians discuss the patient, the transfer facilitators listen to gather more information about the patient's conditions and needs, which will help the facilitator find a bed on the appropriate unit when the transfer is approved.

]"The majority of transfers are approved but sometimes we will delay a transfer if the patient is too unstable to travel," said Elizabeth Ciotti, RN, senior manager, Bed Management. "We're dealing with critical patients, and many have multiple conditions."

Once a transfer is accepted, the paramedic gets the patient's demographic and insurance information from the sending hospital, creates a visit in Epic, then works with YNHH Bed Management to facilitate admission.

Transfers can come by ambulance, Yale New Haven Health System's SkyHealth helicopter or plane. Y Access handles many transfers from within Connecticut and the region, but patients have come from other states and as far away as Europe, Saudi Arabia, the Caribbean and India.

Transfer Facilitator Jim Cannon said one of the most challenging transfers he's worked on involved a patient in Eastern Europe with multiple injuries from a car accident. Because of the patient's fluctuating condition it took over a week and nearly 10 interactions between the referring hospital and YNHH to get the patient here. There was also a language barrier between physicians and 25 pages of medical records in German that had to be translated. Most transfers aren't that complicated, but the Y Access phones can get busy.

"Sometimes the phones are non-stop, and you're handling two calls at once," Cannon said. "It can be stressful, but when you bring a critical patient here, they receive immediate treatment and they're doing well, you know you've made a difference. It's rewarding."

Staffing the Y Access phones are transfer facilitators, clockwise from lower left, Kevin Bodiford, Jim Cannon, Patrick Maher and Mike Granoth.