As a pioneer within HA birthing hospitals to GO Electronic

Abstract Description

Proposed Topic (Most preferred): :

Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)

Authors (including presenting author) :

ChanHK(1), HuiPW(1), KwokSYP(1)

Affiliation :

(1)Obstetrics & Gynaecology Department, Queen Mary Hospital

Introduction :

In view of the global trend in using e-record for patient during hospitalized period and the promotion of environment friendly practice within hospital, the Obstetric team had decided to initiate a pioneer project along with the other HA birthing hospitals to develop an electronic intrapartum fetal monitoring system. As this was the first GO-ELECTRONIC project within HA birthing hospitals, we conducted the project into 2 phases for staff adaptation and system development. In the first phase, focus was development of electronic intrapartum documentation to replace handwriting progress notes, treatment sheet and nursing Kardex for both obstetricians and nurse-midwives. In the second phase, further reduction of intrapartum paper record and interface of fetal monitoring system with OBSCIS were enabled with the collaboration of HOIT, OBS team and vendor.

Objectives :

1. To initiate project in modernizing Labour Ward with the development of e-intrapartum documentation, including e-progress notes and e-partogram (delivery summary)

2. To reduce human error and enhance workflow by avoiding duplication of data entry via interfacing of Intrapartum fetal monitoring system with OBCSIS

3. To enhance instant data retrieval without tracing of patient record from MRO

Methodology :

1. The OBS team had raised a request for 2015/16 CBV funding in installation of the Intrapartum Fetal Monitoring System in Labour Ward

2. An e-progress note was developed with vendor

3. ADT testing of demographic data and patient information interfacing between CMS and intrapartum fetal monitoring system was completed with the joint effort of HOIT and vendor.

4. Endorsement was seeking in various meetings including MEITAG (14/8/2018); CIPO (15/10/2018); O&G SAG (20/2/2021) for implementation of the interfacing work of intrapartum fetal monitoring system with OBSCIS

5. An e-partogram was developed with vendor

6. Written training material and face to face coaching in using the new system was provided for all Labour ward staff.

Result & Outcome :

1. After installation of the new intrapartum fetal monitoring system, development of e-progress note and ADT testing of the system, computerized intrapartum e-progress note was fully utilized by all obstetrician and LW staff in Oct 2017 with good comments from staff as they no longer need to read the handwriting of colleagues, which can sometimes be difficult to apprehend.

2. UAT testing of 2 system interfacing was completed in 31/8/2022

3. E-partogram was well developed at the end of Feb 2023

4. Parallel running of paper record and e-record was started in Mar 2023

5. Live run of the entire E-system on commenced on 1/4/2023 without problem

The whole project was completed in 31/3/2023 with great success. All intrapartum documentation within Labour Ward have been changed from manual input to electronic record. Workflow of data entry and documentation was streamlined. All staff welcome these dramatic changes as the presentation format is clear and user friendly. With the new system interfacing, it reduces workload and human error in transcription as double entry into two separate systems are no longer required. Most importantly, this pioneer project will be extended to the remaining 7 HA birthing hospitals in the near future. The way forward is to formulate PDF record in EPR so as to facilitate patient care and treatment process without delay.