Authors (including presenting author) :
Lo OYJ, Cheung CT, Leung SF, Lee LMP, Tsoi YK
Affiliation :
Infirmary Service, Department of Medicine, Haven of Hope Hospital
Introduction :
There are two types admission in Haven of Hope Hospital (HHH) infirmary service, Local Infirmary Admission (LIA) and Priority Infirmary Patient (PIP). PIP admission is collaborated with HAHO, while LIA is controlled by unit itself. Previously, arranging patient admissions to the Local Infirmary bed required several labor-intensive and redundant procedures. Once referral received, APN performs the intake assessment within 3 working days even no vacancy; Weekly update is performed by checking the physical existence and general condition for all waitlisted patients; The admission date is also influenced by the availability of the responsible APN and MO. Therefore, new LIA workflow is revamped to address these concerns.
Objectives :
To increase the efficiency of LIA procedure in order to optimize bed utilization in HHH
Methodology :
Streamline the workflow:
• Implement “Vacant bed + 1 day (V+1) admission” strategy: schedule patient’s admission for the day after the bed becomes vacant
• Perform intake assessment when there is a vacancy.
• Expand admission during long holiday, such as Chinese New Year.
• Template the intake assessment and printed onto a label.
• Revise internal transfer reminder for a more precise instruction to referent ward.
Modify weekly infirmary bed status and patient waiting list notification system:
• Combine the separated bed status report and patient waiting list into one-page-summary to provide the situation at a glance
• Adapt a new method on weekly waitlisted patients review for APN:
• check the physical existence for all waitlisted patients.
• update the condition for the first three waitlisted male and female patients.
• computerized the conventional paper form, and adopt shared point technology for mutual update at everywhere.
Result & Outcome :
Data collection:
Compare the efficiency of two workflows in a 14-months retrospective study (1-6-2023 to 30-7-2024, 7 months for each workflow)
Result:
Bed utilization:
• The average waiting time for a LIA is decreased from 5.28 to 1.02 days (80.6% faster in admission rate).
• A vacant bed occupied in days is decreased from 147 to 2 days (98.5% decreased in a bed wastage, equal to increased 1% of infirmary bed utilization).
APN work efficiency:
• Time use on weekly screening is decreased from 40 to 30 minutes (25% increase in work efficiency).
• Time use on intake assessment is decreased from 45 to 39 minutes (13.3% increase in work efficiency).
New LIA is effective in optimizing bed utilization, and enhancing work efficiency of APN.
