Authors (including presenting author) :
Sin CMH(1), Tsang RFH(1), Young MW(2), Yip BCW(3), Ma PK(2)(4), Chow CCK(2), Lo CCH(1), Mak KLK(1)
Affiliation :
(1)Pharmacy Department, (2)Department of Paediatrics & Adolescent Medicine, (3)Information Technology Department, (4)Nursing Services Division, United Christian Hospital
Introduction :
With the growing need for hospital beds required for sick patients, improving patient flow in hospitals is an essential issue. The delay in discharge because of non-clinical decisions affects cost and quality of care. Effective discharge requires the support of a multidisciplinary team to proactively address needs, ensuring patients are ready for discharge when medical goals are met. To facilitate patient discharge before 1pm at the paediatric ward (4D) in United Christian Hospital, a task force group consisting of doctors, nurses, pharmacists, and information technology experts was formed to expedite the medication collection process, which was viewed as one of the core principles in optimising discharge.
Objectives :
To measure the impact on time with a modified medication collection workflow, which involved nurses gathering discharge prescriptions and pharmacists vetting prescriptions on ward, alongside the use of a local medication collection notification system (“i-call”). Pharmacist would issue the ticket to the parent or caregiver on the ward, where they could stay with the child and would be notified via mobile phone when the medications were ready to be collected.
Methodology :
This is a single-site, cross-sectional study examining the “ticket-calling” times between traditional and modified workflows. It is defined as the time when the ticket number was being called at the pharmacy window. The data collection period for the intervention was two weeks across August to September 2024. The control sample times were retrieved by randomisation at the same period one year prior to match seasonal variation. An unpaired t-test was performed to calculate statistical significance.
Result & Outcome :
A total of 33 “ticket-calling” times were collected during the study period from each group. The modified workflow has significantly reduced the time for the medication collection process when compared with the traditional workflow, with medications being ready from around 1:41pm (±103mins) to 12:15pm (±18mins), a mean reduction of 86 mins (p<0.05). Although there were other confounding factors that influenced the overall discharge efficiency, this study nevertheless showed how a multidisciplinary effort improved in a key area of the discharge process. Additional benefits such as increased parent-child time, reduced crowdedness in pharmacy waiting area, and pharmacist’s impromptu interventions were also observed but further study is warranted to better understand its impact on medication optimisation. The recognition of the effort not only led the team to receive the KEC SPOT award, but several adult wards have adopted the workflow to improve discharge efficiency as a result.
