Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Authors (including presenting author) :
Jong CW(1), Wong KW(2), Ma KW(1), Chan YK(1), Pun KL(2)
Affiliation :
(1)Medicine & Rehabilitation,Tung Wah Eastern Hospital, (2)Central Nursing Division, Tung Wah Eastern Hospital
Introduction :
Traditional patient Intake & Ouput (I&O) record-keeping often relies on paper-based documentation which is inefficient and prone to transcription errors. With the development of e-I&O in Hospital Authority (HA), TWEH is the pioneer to implement this smart initiative. e- I&O is an electronic platform to illustrate the fluid status of patients over time. It provides a precise and comprehensive real-time information, shared in CMS to facilitate healthcare professional’s clinical decision-making. Furthermore, through e-I&O, patients who require specific intervention, such as, intravenous fluids infusion, can be easily identified, hence, providing a better coordination of care, improving ward management and streamlining patient care workflows.
Objectives :
To implement e-I&O in TWEH Orthopaedic Ward by 4Q2023
To evaluate e-I&O and provide feedback to HA IT team for improvement
Methodology :
Since Apr 2021, representatives from TWEH have participated e-I&O development and usability test in HAHO. Then, a multidisciplinary working group was established in 2Q2023 for the local implementation. Work lists and data sets for e-I&O were set up according to the workflow and daily routine. With joint efforts of HA IT members, the Production Drill was performed as scheduled. Training, including its application and benefits, was provided to nursing & supporting staff. On-site return demonstration was done to ensure staff readiness and competency. A communication platform on progress update and timely feedback mechanisms were set up for staff to engage their participation. Briefing sessions followed by emails with short video and quick tips, were provided to all TWEH staff and cluster hospitals to notify the e-I&O implementation.
Result & Outcome :
The pilot of e-I&O has been implemented smoothly in TWEH since 31st October 2023. Healthcare professionals can use e-I&O to review and monitor the intake and output of all inpatients in the Orthopaedic Ward.
In the satisfactory survey of staff (n=24), 79% (n=19) of staff were satisfied with using e-I&O. 66-83% (n=16-20) of staff agreed that it is easy to use e-I&O, e-I&O can facilitate communication/handover, reduce transcription errors, enhance the efficiency and the quality of patient care. 87.5% (n=21) suggested to continue using e-I&O while 83.3% of staff (n=20) recommended to use e-I&O in other settings.
Conclusion
The implementation of e-I&O improves patient’s fluid management and enhances the efficacy of care process. It facilitates seamless information exchange and coordination among health professionals and improves patient safety and care quality. In future, e-I&O would be promoted to other inpatient wards in TWEH, hence reducing errors, streamlining workflows and enhancing patient-centric experience.
Implication and Benefit
The success of implementation of e-I&O sets as a precedent for other healthcare professionals to adopt electronic systems. It paves the way for a more efficient and patient-centric care.
