Authors (including presenting author) :
LAM YY (1), LAM CY (1), Lai SW (1), Yuen WH (1)
Affiliation :
(1) Medicine & Geriatrics, Pok Oi Hospital
Introduction :
Transient elastography (TE) is a non-invasive method to assess liver fibrosis in patients with chronic liver disease by measuring liver stiffness. In Hospital Authority (HA) hospitals, most TE examinations are performed by gastrointestinal (GI) nurses. However, report formats are different between hospitals. TE reports in one hospital may not be transferrable to other hospitals or clusters. After discussion among the GI nursing workgroup, together with the cooperation of HAHO IT colleagues, we created a standard format of TE report and planned to implement in all hospitals where TE is performed.
Objectives :
1. To standardize and align the TE report format among HA hospitals
2. To create a designated storage location for TE reports so that it can be retrieved in all HA hospitals
Methodology :
Most TE examinations are performed by GI nurses in HA hospitals. Report formats vary from hard-copies to images stored via Digital Screen Apps (DSA). TE results were entered in nursing notes or consultation notes manually. Physicians can only find the results by viewing these notes without accessing to the formal report via the Clinical Medical System (CMS). Storing and retrieving multiple report images in CMS via DSA is not convenient and practical either. And hence, the TE report is difficult to retrieve after patient transferal to another hospital.
In Pok Oi Hospital (POH), GI nurse cooperated with our Associated Consultant, drafted a TE report format which can be retrieved from CMS. With the help of the local IT department, the electronic version of the TE report is in use since 2022 1Q. A new function was created so that TE results can be entered in an electronic form and uploaded to ePR > Other investigation. Physicians could retrieve a standardized electronic TE report in a designated location via CMS. All Physicians are satisfactory with the new function and format. With the promotion among the GI nursing workgroup, various hospital also adopting and implementing this format and function.
Result & Outcome :
In 2021 1Q, TE report (POH format) was created by POH GI team and local IT department. It is in use since 2022 2Q. All TE performed, standardized reports are generated and stored as PDF, together with nursing notes entry in CMS. Physicians can retrieve formal report with results and reference ranges easily. This new format is supported by GI nursing workgroup. In 2022 3Q, with the support of the HAHO IT department, we decided to take POH format as the reference to align the report format in all hospitals where TE are performed by GI nurse. GI nurse would only need to enter TE result readings and report would be generated and displayed on the nursing notes and uploaded to the ePR system simultaneously.
Hopefully, standardization of TE report scheme would be stated in 2023 2Q and to be implemented in all HA hospitals where TE are performed by GI nurse in Big Band Approach. Therefore, continuity of care can be maintained regardless of patient transferal among all hospitals.
