Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Leung TS Sammi, Yu KH, Cheng KH, Au WY, Wong MY Amy
Affiliation :
Occupational Therapy Department, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Occupational Therapy (OT) Department of Ruttonjee & Tang Shiu Kin Hospital has been providing assistive devices (AD) such as heel protectors and hand mittens to different wards for more than 6 years. Both wards and our department are facing manpower shortage and high turnover rate of staff in recent years. Since AD system relied on both ward and OT staff for smooth operation, problems of not returned AD and missing AD referrals were surging under the circumstances of insufficient manpower. AD cost was increased with missing AD. Extra time was required to manage AD production, prescription and staff education regarding to AD workflow. Thus, we have evaluated and enhanced the AD service package.
Objectives :
1. Reduce prescription time and cost of AD
2. Ease both ward and OT staff workload and reduce missing rate in AD prescription
Methodology :
The enhanced AD service package includes: Revised prescription materials (AD issuing record form and poster), new type of heel protectors. QR codes were incorporated in poster for easy access to the materials and to facilitate communication between ward and OT department. New heel protectors were used to minimize production time and further reduction of heel pressure. Outcome measurement includes: AD prescription missing rate, mean AD prescription time, mean reduction of pressure over heel and user satisfaction survey.
Result & Outcome :
10 bed-chair bound cases were selected to use the new heel protectors. The mean pressure over heel of new heel protectors was reduced by -64.8%, whereas the previous heel protectors was -23%. None of them developed heel sore during the study period.
The mean prescription time of AD was shortened from 3.5 hours to 2 hours, thus more time was available in monitoring of patients’ skin condition and provide patient care. The missing rate of AD prescription was reduced from 20% to 12%. The average production cost maintained at about $50. A 10-point-scale satisfaction survey for staff was conducted. The survey focused on (i) effectiveness of revised materials and (ii) patient care with prompt OT follow up. The mean score of (i) and (ii) was 8.7/10 and 8.6/10 respectively. The mean overall satisfactory level for the AD system increased from 6.5/10 to 8.7/10.
The AD service package enhancement has been proved successful in minimizing time and AD cost.
