Authors (including presenting author) :
Li MY(1), Wong KY(1), Wu KM (1), Lau SY(1), Ng WF(1), Tang PY (1)
Affiliation :
(1)Department of Surgery, United Christian Hospital
Introduction :
Surgical Department is facing many challenges in these years such as UCH re-development, ageing population and rapid population growth in Kwun Tong district, escalating service demand and ward congestion. In order to tackle the high ward occupancy and access block in AED, a Discharge Coordinator Pilot Program has been launched since December 2019.
Objectives :
(1) To shorten the length of stay (2)To reduce unplanned re-admission (3)To speed up discharge process (4)To better utilize the rehabilitation bed (5)To ensure continuity of care
Methodology :
(1) Speed up patients discharge and transfer process. Discharge the patients by noon time, free hospital beds for planned admission and emergency cases: (1.1) Prepare discharge documents in advanced. (1.2) Utilize efficiently the discharge lounge. (1.3) Empower all frontline nurses for facilitating the discharge process. (2) Coordinate and reorganize the elective admission cases. Conduct pre-admission screening of elective cases to minimize unnecessary admission and ensure better utilization of hospital beds: (2.1) Re-direct inpatient to ambulatory care centre (e.g., colonoscopy, CT rehydration, Barium enema and CT colonoscopy). (2.2) Re-direct inpatient to outpatient or same day admission (e.g., OGD and ERCP). (2.3) Arrange admission blood test. (2.4) Call patients for pre-procedure preparations (e.g., bowel preparation or withholding anticoagulant). (3) Promote discharge planning for post-operative patients and handle discharge problem cases :(3.1) Screen the patients with discharge problem. (3.2) Explore the difficulties of patients and families and handle with multi-disciplinary approach. (3.3) Refer early rehabilitation and monitor the rehabilitation bed waiting time (3.4) Refer appropriate cases to St Teresa Hospital low charge beds. (3.5) Keep patients and relatives updated about the discharge plan. (4) Initiate phone follow up. Identified high risk groups for phone follow up after discharge to reduce unplanned readmission since October 2021.
Result & Outcome :
From 9th Dec 2019 to 30th Nov 2021, (1) Total 1521 patients were recruited in the program, 90% of patients were discharged by noon since May- Nov 2021 compared with 25% in the first month the program started. (2) Pre-admission screening of elective cases had saved 1359 bed days (3) Patients were transferred to HHH rehabilitation bed within 8 days, compared with 10 days in the first month the program started.
