Authors (including presenting author) :
Hon Wah Ng, Shu Wing Kung, Kin Pang Yau, Chung Yan Lee, Hin Son Li Hinson, Tin Li
Introduction :
Title: Enhancing Patient Outcomes with a Specialized Toxicology Service and Comprehensive Poison Registry
Background:
In response to a recognized need for specialized care in toxicology, a dedicated team was established in August 2022, bringing together medical, nursing, and administrative professionals with expertise in toxicology. Concomitantly, a poison registry was introduced to facilitate the systematic capture of data pertaining to toxicology patients.
Methods:
This study conducted a retrospective analysis of toxicology cases recorded in the poison registry, comparing data from three distinct periods: pre-implementation (June 2022 to July 2022, N=41), period 1; first five months post-implementation (August 2022 to December 2022, N=159), and period 2; second five months after the Toxicology Service implementation (January 2023 to May 2023, N=131).
Results:
The demographic analysis revealed that 58.7% of cases involved females, with a mean patient age of 32.4 years. Pharmaceuticals were the most frequent cause of toxic exposure (42.2%), with bites and stings also representing a significant proportion (29.0%).
Key changes were observed in following areas when we compared the parameters in the pre-implementation period to that of period 2 (five months after the Toxicology Service implementation)
A decrease in mean ED waiting time from 48.8 min to 37.8 min
For admitted patient, including those to EMW or clinical ward, a decrease in mean hosptial length of stay from 2.06 day to 1.36 day
A trend of reducing prolonged hospital stay was observed
Rate of patient discharge directly from AED after assessment and treatment increased from 34% to 55%
Rate of hospital admission, excluding to EMW decreased from 43.9% to 24.4%
Rate of EMW admission were similar among the 3 periods; namely 22%, 22.6%, 20.6%
Conclusion: The establishment of a specialized toxicology service along with the poison registry has tangibly enhanced the quality of care, as evidenced by multiple performance metrics. The registry has proven instrumental in gathering detailed data, which has been pivotal in identifying and capitalizing on opportunities for the ongoing refinement of evidence-based care. Continuous evaluation and analysis of the registry data are crucial to ensure the sustainability of these improvements and to further advance the delivery of optimized, evidence-based toxicology care.
