Authors (including presenting author) :
CHEN K K (1), CHOY F (1), YEUNG W S (1), CHAN N Y (1), CHEUNG E (1), MOK M L (1), YUE N T (1), PAK C H (1), LO L H (1), HO Y Y (1), WONG Y F B (1)
Affiliation :
(1)Medicine & Geriatrics Department, North Lantau Hospital
Introduction :
With the launch of Convalescence & Rehabilitation (CR) bed booking system and electronic documentation (eDoc) in Extended Care Ward (ECW) of North Lantau Hospital (NLTH), the admission workflow of patient transfer from Princess Margaret Hospital (PMH) was reviewed for enhancement of patient experience and safety in 2024. As liaised with Accident and Emergency Department (AED), Supporting Department and Non-Emergency Ambulance Transportation Service (NEATS), the waiting time of patients from loading area upon NEATS arrival to ECW and portering service times for transferring patients to designated wards had remarkable improvement after the enhancement.
Objectives :
1.To streamline the admission workflow of patients from PMH
2.To minimize the risk of patients being left unattended at the loading bay
3.To reserve AED & M&G manpower for clinical needs as much as possible
4.To expedite the admission process by collaborating with portering service and NEATS
Methodology :
Process re-engineering about the admission workflow of patients from PMH to NLTH ECW:
1.Ward allocation one day before transfer via CR bed booking system in CMS by ECW nurse in-charge.
2.On the day of transfer, NEATS control reserved orders to NLTH Porters in ADS after the list of patient transfer had been confirmed. Porter would also receive the updated patient list from ECW by Fax.
3.On Arrival to NLTH:
a.Patients would be unloaded to NLTH stretcher/wheelchair by NEATS and handover to Porter with patient’s name & ward location.
b.ECW Nurse would be called by Porter once NEATS arrival for patients with oxygen therapy and would go to loading area as soon as possible for checking those cases to ensure patient safety.
c.Patients would be transferred directly by Porter to designated ECW after NEATS handover or ECW Nurse checking. At the meantime, all PMH patient notes would be delivered to Admission Office by Porter and sent back to designated ECW while patient’s eDoc via CMS could be initiated seamlessly by M&G staff once admission process is completed.
d.AED support would be required whenever necessary and in emergency while arrival in NLTH loading area.
Result & Outcome :
According to original workflow, the average waiting time upon patient’s arrival to NLTH was about 30min at the loading area for admission registration and AED nurse checking before arrival to designated ECW. Potential risk of change of patient conditions while waiting at the loading area, and prolonged utilization of supporting & NEATS services were substantially noticed.
With the admission workflow enhancement in ECW since February 2024, the average waiting time upon patient’s arrival to NLTH was shortened in 5mins with 83% improvement compared to the original workflow at the loading area. The overall portering service time for all patient from loading area transferring to designated ECW was shortened from 45mins to 25mins with 44% improvement in daily basis. Incident for unattended cases or oxygen-related issues could also be minimized after the new workflow implementation.
Overall, this admission workflow enhancement has achieved the objectives to improve the safety of patient transportation upon arrival NLTH to ECW and extend the provision of quality care for patients.
