Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Chan HM(1), Li YN(1)(2), Leung KLD(1)(2),Lee SC(1)(2),Sun TFD(1)(2)
Affiliation :
Department of Accident and Emergency, Department of O&T, Department of Surgery, Department of Medicine, Central Nursing Division
Introduction :
The persistent challenge of access block has posed a significant obstacle for frontline healthcare professionals. In August 2022, three patients had to endure a 12-hour wait for admission, prompting the hospital to scrutinize the admission flow within the overarching framework of patient-centric care. Issues identified included a cumbersome admission process, insufficient bed coordination information, a lack of real-time updates, and delayed patient discharges. In response to these challenges, the nursing team collaborated to develop prototypes the Emergency Admission Dashboard (EAD) and Bed Status Dashboard (BAD). By improving communication and providing real time information, the two dashboards aim to optimize patient flow by streamlining the admission process and improving bed assignment coordination.
Objectives :
The study aimed to evaluate the efficiency of the emergency admission process after the introduction of the EAD and BSD.
Methodology :
The Admission waiting time and the proportion of patients with access block will be assessed and compared before and after the implementation of the two dashboards. A satisfaction survery will be conducted among the ward nursing colleagues.
Result & Outcome :
The implementation of the EAD and BSD at NDH yielded significant improvements in admission waiting times. Out of the 27,732 emergency admissions recorded between February to December of 2023, average 61% were admitted within 1 hour, only 5.6% of patients were admitted within 4 hours. Yet, 0.1% of patients were admitted within 8 hours.
Comparing these results to the same period in 2022, 17% of patients were admitted within 4 hours. Percentage of admission within 4 hours has improved by 11.4% after the implementation of the initiatives.
The implementation of the EAD and BSD also led to a significant reduction in phone calls required for each emergency admission from a minimum of 5 calls per admission previously to 2 calls. This resulted in a time saving of 693 hours during the study period.
A staff satisfaction survey was conducted with a response rate of 59.5% (N=75) and revealed a high overall satisfaction rate of 95%. Specifically, 95% of respondents found the EAD actionable, 95% reported that it facilitated bed assignment, and 91% agreed that it reduced the number of phone calls. In conclusion, the EAD facilitated communication between AED nurses and bed coordinators, while the BSD allowed real-time updates and viewing of bed availability, optimizing bed arrangements. The initiatives are slated to be integrated into the corporate system and rolled out to other hospitals.
