Authors (including presenting author) :
Li MY(1), Wong KY(1), Ng WF(1), Tang PY(1), Law N(1), Li N(1)
Affiliation :
(1)Department of Surgery, United Christian Hospital
Introduction :
The COVID epidemic situation was severe in 2021 & 2022, private hospitals allocated beds to receive patients from Hospital Authority (HA) to reduce the burden on the public health care system. STH (St. Teresa’s hospital) low charge bed Program restarted on 1/12/21, Other private beds started to receive UCH patients since 2022.They included SPH (St Paul Hospital), GEHK (Gleneagles Hospital), HKBH (Baptist Hospital) and CUHK (CUHK medical Center). A Discharge Coordinator Pilot Program was initiated in the Department of Surgery, United Christian Hospital (UCH)to tackle the high ward occupancy and access block in AED. Coordinating with Nursing Service Division (NSD), UCH, the program acted in the role to facilitate the transferal of surgery patients to private beds.
Objectives :
(1)To shorten the length of stay (2)To facilitate appropriate patient transferral to Private hospitals (3)To better utilize the reserved private beds (4)To ensure continuity of care
Methodology :
(1) Referral screening stage: (1.1)Promote and introduce the program to ward nurses and doctors. (1.2)Remind doctors to screen during doctor round. (1.3)Coordinate with ERAS nurse, CCM for referral of post- operative patients. (1.4)Collaborate with physiotherapist to provide rehabilitation plan and referral to fit transferal criteria. (1.5)Round ward to recruit suitable cases. (2)Communication after case selection: (2.1)To ensure proper support to surgical specific care, such as complicated wound, stoma, PTBD flush, drains, PICC available at receiving hospital. (2.2)Explain the program to patients and relatives for consent. (2.3)Co-ordinate with private bed coordinator, team doctors, patient, and relatives, work out an agreed discharge plan. (2.4)Communicate with relatives, CNS, MSW and ICDS to ensure the home support available. (2.5)Provide structured guidance to clinical staff with Preparation checklist and answer related telephone enquiry (3)During private hospital stay: (3.1)Support continuity care including MSW referral, arrange document, medication and Neat booking for follow up when necessary. (3.2)Arrange communication among private hospital team with parent team. (3.3)Arrange appropriate wards, team and communicate with the involved parties upon backflow. (4)Upon discharge from private hospital: (4.1)Refer CNS, ICDS if necessary. (4.2)Provide discharge documents received for parent team doctors’ review. (4.3)Suggest doctor to update the medication profile in CMS to enhance communication. (5)Evaluate the coordination process with NSD. Discussion ,comment seeking and improvement planning were performed .
Result & Outcome :
(1)From 1/12/21- 31/12/22 (13 months), 371 UCH surgery patients transferred to private hospital: STH(N=279), SPH(N=65), GEHK(N=12), HKBH(N=14), CUHK(N=1). Compared with previous program implementation period: STH (N=6) within 3 months in 2018, STH (N=6) within 5 months in 2019, STH (N=29) within 12 months in 2020.STH (N=17)within the first 5 months in 2021(January–May) (2). Within 2/8/22-30/12/22 data collection period (5 months), referring to length of stay in private hospital, total 1849 UCH surgical bed days saved.
