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): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Leung HY, Lai ML, Yip H
Affiliation :
Department of Medicine & Geriatrics, Kwong Wah Hospital, Kowloon Central Cluster
Introduction :
Hyperacute Stroke Management Service is a 24/7 service in collaboration with the Acute Stroke Unit (ASU), the Accident and Emergency Department (AED) and the Department of Diagnostic and Interventional Radiology (D&IR), for providing timely intravenous thrombolysis (IV-tPA) service to acute ischemic stroke patients. To safeguard patients’ safety and ensure the service would be maintained during the commissioning, pre move-in inter-departmental drill and on-site visiting for stroke nurses, are necessary before move-in to the new Kwong Wah Hospital (KWH).
Objectives :
- To assess the effectiveness of the protocol and identify any potential risks or shortcomings of the service in the new environment. - To assist personnel to familiar with the new environment and understanding their roles and responsibilities when providing service in accordance with the protocol in the new KWH building.
Methodology :
Phase 1: Formulate workflows for Hyperacute Stroke Call in the new building and conduct inter-departmental drill. Phase 2: Identify problems and make appropriate recommendations for discussion. Phase 3: Review the workflows if indicated and provide on-site visiting in the new building to all stroke nurses before move-in. Phase 4: Review the service after move-in.
Result & Outcome :
- The inter-departmental drill has been conducted on 11th May 2023 with 3 different patient scenarios performed. - The transportation of patient from AED in new building to ASU in old building was found unfavorable in the drill. To enhance patient’s safety, the workflow on patient’s admission has been revised and on-site support by stroke nurse in the new building has been arranged within this period of time. - Way finding was a challenge encountered in the drill, so more signage have been added to reduce the impact on the service. - On-site visiting for the Hyperacute Stroke Call in the new building has been provided to 17 stroke nurses before move-in. All of them were satisfied with the arrangement. - SMS Group call has been implemented to replace traditional phone calling for Hyperacute Stroke Service activation and enhance effective communication among ASU, AED and D&IR colleagues. - After move-in, the mean of Door-to-Plain CT Brain Time reduced from 45 to 27 minutes, and about 8% more patients could achieve Door-to-Needle Time within 60 minutes on IV-tPA treatment.
