Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Lam TT, Chung CFJ, Wan KS, Lo YT, Wong HK, Lui HT, Yeung CK
Affiliation :
Department of Medicine, Tseung Kwan O Hospital
Introduction :
The thrombolysis service is one of the major services provided by the stroke team at TKOH 24 hours a day, which requires stroke nurses to communicate with off-site neurologists during non-office hours. Traditionally, stroke nurses completed paper forms on-site, and the clients' current situation and history were solely reported to off-site neurologists by phone. However, errors or misperceptions could occur during verbal communication, affecting the neurologists' decision on patients’ eligibility for the service. Therefore, a web-based system was developed to enhance communication between stroke nurses and neurologists, increase accuracy, and reduce clerical workload.
Objectives :
This project aims to achieve several objectives. Firstly, it targets to enhance communication between stroke nurses and neurologists. Secondly, it designs to improve the accreditation and accuracy of the thrombolysis service system. Thirdly, it helps to reduce repeated clerical workload at both frontline and management level.
Methodology :
Paper assessment forms and relevant materials were transformed and embedded in a web-based system. The entire electronic assessment form can be emailed to off-site neurologists in addition to verbal reporting by phone. Neurologists' digital footprint was allowed as they replied via email to improve accreditation and confirm patients’ eligibility. The system enhances accuracy through auto-calculations and reduces hand-writing errors. Patient’s data is automatically stored in the system on a monthly basis, enabling easy retrieval and integration into spreadsheets for statistical analysis. A parallel pilot was conducted for a month before full implementation to ensure a smooth transition from paper to an electronic system.
Result & Outcome :
The web-based system was fully implemented in the TKOH stroke team to facilitate thrombolysis services, including IV rTPA and CTA/CTP coupling services for IA mechanical thrombectomy. Positive feedback was received from nurses and neurologists, noting improvements in communication and accuracy. The patient journey in the thrombolysis service is completed through the digital footprint of neurologists. Efficient data storage and retrieval were achieved by eliminating the approximately 15 minutes per patient required for repeated manual data entry and through automated data integration. Ongoing enhancements are being made to include key performance index features in the system for more timely monitoring of service performance. Collaboration with the UCH stroke team is also in progress to align the thrombolysis service documentation within the cluster.
