Proposed Topic (Most preferred): :
Staff Engagement and Empowerment (motivating staff / teamwork / work revamp tackling manpower issue / staff wellness / OSH / retention)
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) :
Fong YL (1), Wong WK (1), To CH (1), Lui CT (1), Ronald Yam (2), Esther Tan (2), Madeleine So (2), Edwin Lo (2), Peter Chan (2)
Affiliation :
(1) Specialist Out-patient Clinic (SOPC) NTWC, (2) HIRO Department, NTWC
Introduction :
According to NTWC SOPC statistic, yearly attendance was > 640000 in 2023. Retrieving and filing of huge amount of patient ‘s medical folders daily were big issues of manual handling operation and time consuming for staff of HIRO & SOPC. To minimize those pain points, Folderless Consultation with Smart Label printing has been fully implemented by phases in NTWC SOPCs. TSWH SOPC 4/2011; POH SOPD 1/2022 and TMH ACC 8/2023 (except Gynaecology clinic). To implement Folderless Consultation, one of main obstacles was identified by team members: A4 patients’ label should be pre-printed and ready in patient folders during consultation for various usages by doctors. The top management strived for the changes and Smart label has been created and used in TSWH since 2/2021 which was a great mile stones to step forward for Folderless Consultation in SOPC. After discussion with all stakeholders, clinic workflow was reformed. All staffs satisfied for the changes, occupational safety was enhanced, paper generation minimized and time saved for patient medical folder retrieval and filing.
Objectives :
To minimize the outdated hardcopy medical records storage in patient’s medical folder To minimize the risk of MHO issue To save the time in handling of patient’s loose sheet and filing documents To become an environmental friendly To enhance the efficiency of record filing and clinic workflow To eliminate the risk of losing patient’s documents
Methodology :
Firstly, the top management proposed the project and gained consensus from all stakeholders in various clinics and presented to concerned parties how to implement Folderless Consultation with using “On demand label printing function”. In order to facilitate the project, consultation summary was set as default for "no auto print" after doctor consultation. Loose sheets returned to HIRO were dramatically decreased. For preparation stage, the transparent zip bag was redesigned and separated for new and old cases. All GCRS label printers and consumables were ready. For implementation stage, all stakeholders agreed for trial run in SOPC TSWH in 4/2021. The workflow was briefed to HIRO staff, they would put the remote printing slip into a designated transparent zip bag when patient registered via registered counter/HA Go/Kiosk. No A4 size of patient labels should be printed. The zig bags would then be transferred to SOPC nurse station within 2-3 minutes. Medical record folders could be ad hoc requested by doctors, processing time within 15 mins. After the clinic session finished, supporting staff would collect the transparent zip bags +/- documents to Registration Office.
Result & Outcome :
The Folderless Consultation with Smart Label printing in SOPC was implemented with uneventfully. All staffs welcomed for the project. The transparent zig bag was much lighter than the original medical patient record. The weight of folder reduced to only 1.5% (The folder average ~2kg). After changes, NTWC SOPC folder weight to be managed yearly was significant reduced from 530 to 7.9 Cargo container. HIRO staff no need to retrieve the medical folders for doctor consultation which could reduce around 30 second manpower per folder. They saved 762.7 man-day per year in total, so that they could focus to other main duties. For environmental friendly, 1281398 papers/~14 trees would be saved per year. The total height increase of patient medical folders was significant trimmed down to 10% per year, the storage space of hardcopy in HIRO and SOPC was saved. The efficiency of record filing, clinic workflow and Occupational Safety were enhanced. Folderless Consultation with Smart Label has been fully implemented in SOPC NTWC since 9/2023. All achieved outcomes were encouraging. All stakeholders welcomed for the Smart project and those improvement works. In future, we will promote more paperless program such as paperless ECG, document scanning the private report and upload to ePR in CMS. The way forward is to share these good practices to other SOPCs in Hospital Authority.
