Authors (including presenting author) :
Leung YL(1), Chu MW(1), Li KY(1), Lai SC(1), Au YL(1)
Affiliation :
(1) Department of Rehabilitation and Extended Care, TWGHs Wong Tai Sin Hospital
Introduction :
Longer life expectancy is one of challenges facing in Hong Kong. It is projected that 33.3% of the total population will reach 65
years old or above in the year 2039. "Ageing-in-Place" & "Elderly Friendly" is a universal concept accepted as fundamental to new setting of hospital ward design.
In TWGHs Wong Tai Sin Hospital Department Department of Rehabilitation and Extended Care (DREC), the facilities of ward setting of two infirmary wards are over nearly 30 years and cannot accommodate the current complicated geriatric need. With the supporting of hospital funding, our team performed a renovation project to re-design ward setting based on "Elder Friendly"concept from period September 2019 to September 2020. Because of renovation, one infirmary ward need to receive convalescent case and become mixed gender ward.
Objectives :
1. Re-engineering of workflow for two wards 2F dual specialties (infirmary bed 33 and convalescent bed 15) with mixed gender and 3C convalescent ward (convalescent bed 43)
2.Meeting increasing needs of geriatric and infirmary care
3.Enhancing fall prevention and barrier free access
4.Managing the potential risk, and providing safety work environment for staff proactively.
5.Promoting carer partnership with carer
6.Enhancing patient observation and infection control measures
7. Providing better Manual Handling Operation (MHO) and safety.
Methodology :
Re-design ward setting:
1. Prevention fall: Re-design lighting support for better sightseeing, handrails in corridor/toilet and shower room
2. For cognitive impaired elderly patients: Painting provide positive live meaning, contrast bright wall colour, distinctive pattern of floor mat are adopted as signage effect
3. Barrier free access design in patient bath room and toilet
4. Installation of ceiling hoist to minimize MHO during patient transfer
5. Enhance infection control measures: Flexible partition to divide one to two single rooms,transparent mobile screen for isolation case to enhance patient observation
Re-engineer the workflow
6. Carer partnership: Bedside or phone contact on updating patient condition with relatives, proactive interview by supervisor,peer group sharing activity, tea party, video call (after outbreak of COVID 19)
7. Enhance patient observation: Consolidate ward round system and mini-work stations to facilitate patient observation and high risk of fall case
Result & Outcome :
To patient: With redesigned hardware support, workflow and carer partnership, the trust relationship is enhanced. Positive feedback from relative are increased.
To staff: The working space is broadened. Replacement the transfer board by ceiling hoist to all bed to bed patient transfer and reduce MHO or heavy lifting for over 90% dependent patients, no injury incident related to narrowing workplace or heavy lifting has been reported. Positive feedback from staff in new setting reported
Conclusion:
New ward environment using concept of "Elderly-Friendly" and re-engineering of workflow for tow wards facilitate service quality and safety to staff and patient. New elements such as mini-station, new ward design, care partnership program, installation of ceiling hoist can promote a comfort and healthier environment of patient, relative and staff.
