Authors (including presenting author) :
Lau SY(1), Wu PH (1), Lo KL (2), Kwok H (2), Lai TH (1), Wong CT (1), Kam PYM (1), Yeung C (1), Cheung WS (1), Kwan SY (1), Chiu KF (2), Ng CF (2)
Affiliation :
(1) Day Surgery Unit, Alice Ho Miu Ling Nethersole Hospital (2) S.H. Ho Urology Centre, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
Introduction :
According to the Centre of Health Protection (2020), over 50% of men are affecting by BPH. There is an increasing prevalence of BPH so we are introducing a new service utilizing minimally invasive technologies that can replace traditional surgical methods. These procedures, performed under local anesthesia, significantly reduce the reliance on operating theaters, making them more accessible and efficient. The first phase of this initiative focuses on reducing patient waiting times from an extensive 12 months to just 4 months. By establishing a one-stop service at the DSU in AHNH, we aim to alleviate pressures on hospital bed occupancy while providing timely care. In the second phase, we aspire to increase service capacity to accommodate more patients and reducing waiting times. This project not only addresses the urgent needs of BPH patients but also represents a significant advancement in the delivery of ambulatory urological care in Hong Kong.
Objectives :
I) To establish a comprehensive workflow for minimally invasive surgical treatment (MIST) procedure per patient, thereby increasing the overall service capacity. II) Shorten patient's care journey by reducing patient waiting times and alleviating hospital bed occupancy pressures through the new one-stop service initiative at the Day Surgery Unit (DSU) in AHNH.
Methodology :
I) Develop New High-Flow Surgical Service at the Day Surgery Unit (DSU). The treatment room was modified to include all necessary facilities for conducting the procedures. To ensure optimal quality and safety, collaboration with Infection Control, Supplies, and Administration was essential. II) Develop Nursing Workflow: The nursing team acted as the primary case managers, overseeing patient monitoring and evaluation throughout this innovative day procedure. We conducted comprehensive screening, assessment, and follow-up for patients at the center. Consequently, the post-procedure infection rate has remained at 0%, and this outcome is currently undergoing evaluation.
Result & Outcome :
A total of 250 patients have successfully undergone surgery at the Day Surgery Unit (DSU) in AHNH, which operates exclusively as a day procedure setting for trial from 1/11/2022 to 31/12/2024.
I) Efficiency Improvements: - Reduced surgical time and costs through advances in surgical and local anesthetic care. - Conducts MIST every two weeks. - Procedure Duration: Initial trial cases took approximately 1 to 1.5 hours, now reduced to 15 to 30 minutes per case. - Capable of handling up to 8 cases in a session. II) Patient Outcomes: - For non-catheterized patient: -Decreased waiting times for BPH treatment from 12 months to 4 months. Forcatheterized patients, who eligible for surgery within two months, committment rate was 65% in compared with 40% before MIST programme. - Significant reduction in post-procedure complications.
