Authors (including presenting author) :
Yuen PS(1), Wong WYW(1), Tong YHA(1), Chan HS(1), Kwong YOE(1), Leung CMY(1), Lau WTL(1), Cheung NT(1), Lui CT(2), Tse CFB(2)
Affiliation :
(1)Information Technology and Health Informatics Division, Head Office, Hospital Authority, HKSAR, (2)Department Accident & Emergency, Tuen Mun Hospital, HKSAR
Introduction :
Accident & Emergency Department (AED) is responsible for 24-hour emergency medical services with highest caseload for inpatient admission and discharge amongst all departments. Rapid patient location identification is the key for efficient healthcare delivery, so as to cater the high service demand and rapid patient condition change. Within an AED episode, patient would be assigned to various clinical areas for healthcare, such as triage cubicle, consultation room, treatment area, observation room, etc. It was observed that patients with similar healthcare needs would be assigned to same area to facilitate healthcare delivery. However, with rapid condition change of AED patients, healthcare needs may not be the most applicable indicator to refer patient location. Also, the practice to assign patients in specific area may be revised dynamically up to local clinical setting, latest AED service usage and current dominant patient group. AED healthcare team commonly finds difficult and time consuming to identify relevant patient under crowded and dynamic AED environment. Provision of customized and updated surrogate patient location is a key for accessing relevant patient for all types of healthcare delivery. Moreover, it can also save unnecessary workforce for searching patient from various clinical areas and enhance working efficiency by improving patient accessibility.
Objectives :
1. To develop a local-maintained module under A&E Information System (AEIS) for each AED to define AED location applicable to local clinical setting 2. To create a function under AEIS for AED colleague to update patient surrogate location if necessary
Methodology :
A pilot project of AED Location Documentation feature was deployed in Tseung Kwan O Hospital and Pok Oi Hospital AED in December 2022. With the advice from AED IT Working Group, the functionalities of the AED Location feature include but not limit to the followings: 1. A local-maintained module for each AED to define and edit AED location applicable to the latest clinical setting. 2. Provide location view and computer view in AEIS to support patient identification and accessing related clinical documentation. 3. The defined AED location can be filters of all AEIS patient lists. It can support easier progress tracking for a targeted group of patient under same AED location. It can further facilitate manpower allocation to support operational management. 4. AED location information is integrated with Smart Care Centre for applicable COVID patients to support better COVID case management.
Result & Outcome :
After one-month pilot in TKO and POH AEDs, it was observed that the surrogate location was documented for specific types of patients such as airborne infection isolation, pending COVID test result upon triage, etc. Positive feedbacks from AED colleagues regarding its added value in paperless clinical workflow were received. The AED Location feature will be further rolled out to remaining AEDs from Jan 2023. Improvement in user experience, enhanced patient identification and better healthcare efficiency would be expected. Further evaluation is needed after rolling out to all AEDs.
