Authors (including presenting author) :
Poon A (1), Law YS (1), Leung WY (1), Liu CF (1), Hui N (1), Wong KK (1)
Affiliation :
Occupational Therapy United Christian Hospital
Introduction :
Facing to population aging, increasing service demand and challenging of new normal. Geriatric Day Hospital Occupational Therapy (GDH OT) modernization is needed to improve efficiency, quality of care and improve communication. A self-initiated in-house structured modernization and transformation by infusing creative workflow, innovative technology and staff empowerment & engagement.
Objectives :
To improve service quality of care, enhance clinical & operation workflow efficiency and have timely clinical information to facilitate resources mobilization. Also, to enhance teamwork and improve communication among inter-discipline and intra-discipline.
Methodology :
From 2Q 2020, implementation of electronic documentation, electronic platform of capturing community occupational therapy, restructuring workflow throughout patient journey, applying technology in delivering patient care. Lewin's Change Management Model: Unfreeze, Change and Refreeze was employed. i.Unfreeze: Discuss and get support from senior and GDH management by a series of meeting ;on site and workflow analysis and confirmed suitable for launch modernization and enhancement program;communicate with staff in various meeting include intra-discipline, inter-discipline to make staff feel they are shaping in future and fostering an embrace to change the culture,to address staff's doubts and concerns, organized a trial ii. Change Engage frontline staff and team leader to design future clinical & operation workflow, and this can let them making things differently. Tasks include Paperless: to create electronic documentation templates for clinical documentation standardization, same information accessed by inter and intra-disciplines, to adopt CMS IPAD for case reporting & updating in regular GDH case conference ;Smart workflow: to create GDH OT central record, redesign clinical & operation workflow along patient journey to facilitate efficient clinical operation, to develop SOPs of modified clinical and operation workflow ;Smart logistics: to implement new and practical filing and categorization system of essential materials & documents ;Smart panel: to create an electronic platform for capturing COT relevant information to facilitate within department information accessibility, storage, transfer, record, OT safety and analyze ;Smart clinical service: to adopt web based information in patient & care giver education and aids prescription to adapt a new normal ;Smart workplace: to adopt new disinfection equipment (UVC chamber) to facilitate infection control requirement /demand and efficient operation flow, to establish intensive staff training and communication among team & across-disciplines in GDH operation meeting iii. Refreeze ,Regular review meetings were held to review, modify and sustain workflow and modernized tasks after implementation ;Regular audit includes documentation and protocol audit
Result & Outcome :
100% staffs agreed the modified clinical & operation flow. Efficiency enhanced with 50% time saved (from more than 60 minutes to 30 minutes) in daily operation process. Teamwork communication improved with timely update & retrieve GDH OT AHPN in CMS and it could be accessed by inter-discipline & intra-discipline timely. Community Occupational Therapy related records could be accessed by clerical staffs & different phase of Occupational therapist effectively. Resource allocation optimized with space saved from old filing system, spare extra cabinets / space for storage, clinical education use and OSH corner. Cost saved from fax machine toner and paper. Also, culture built with influenced other discipline to transform electronic documentation. CONCLUSION A self-initiated in-house structured modernization and enhancement by infusing creative workflow, innovative technology and empower & engage staff can improve efficiency, enhance quality of care, better communication and care coordination. A successful change needs top management support, and a sustainable change needs frontline engagement.
