Authors (including presenting author) :
Li YK (1), Chiu WK (2), Ho YC (2), Fung G (2), Liu KS(2) , Bao J (2), Tam WS (1), Wong PS (1),Cheung T(1), Kwan KY (1)
Affiliation :
(1) Special Out-patinent Department,(2) Paediatric & Adolescent Medicine Department.
Introduction :
Background
Long waiting times and heavy patient load are challenging problems faced by the UCH Paediatric Specialist Outpatient Clinic (SOPD). In order to improve service efficiency, a new service model (Telehealth) is being developed, which enhances the nurses’ roles in ambulatory service. Nurses can play a key role in filling some important service gaps in our current service. This is illustrated by the new “Prolonged NNJ Phone Results Programme” at the UCH Paediatric SOPD
Objectives :
1. Enhance nurses’ role in ambulatory service
2. Avoid unnecessary follow-up for healthy infants with normal investigation results
3. Avoid overcrowding in the Paediatric SOPD with decrease in nosocomial infection
4. Reduce waiting time and improve efficiency at SOPD
Methodology :
1. Infants referred to UCH Paediatric SOPD with prolonged neonatal jaundice (defined as neonatal jaundice (NNJ) persisting after 15 days of life) are assessed by Paediatric doctors. Healthy infants with no health problems apart from NNJ are recruited into the “Prolonged NNJ Phone Results Programme”. In this programme, blood-test results for infants with prolonged NNJ are screened by Paediatric doctors, and results communicated to parents by phone. Once recruited, doctors will explain the rationale and logistics to parents and obtain agreement for phone contact.
2. A printed education sheet on prolonged NNJ as well as reminder for phone contact are given to the parents. Parents are reminded that nurses will contact them within two weeks with investigation results. A log-book of all recruited infants is kept at SOPD
3. Laboratory results for infants in the Programme are screened daily by senior SOPD Paediatricians. Infants with abnormal results are called back for further management. Infants with normal results are contacted by SOPD nurses and results communicated over the phone
4. SOPD nurses also follow up on the infant’s condition and provide education to parents as necessary during phone contact. Any problems are referred to SOPD Paediatrician-in-charge
5. SOPD nurses document clearly the date, time and contact person for phone results as well as questions discussed and final outcome
Result & Outcome :
Result: 375 infants were recruited into the “Prolonged NNJ Phone Results Programme” from 24th Jan 2019 to 30th Nov., 2019. 12 infants (4%) had abnormal results and were called back for further management. 363 infants (96%) had normal laboratory results, and those were communicated to the parents by phone, with no follow-up needed. This leads to a decrease in SOPD workload and increases the capacity to take up both Paediatric old and new cases. As a consequence, SOPD can take up 32 additional old Paediatric cases per month, and the SOPD waiting time is significantly reduced. All 375 patients are satisfied with the arrangement. Conclusion: The programme of phone notification results in significant shortening of SOPD waiting time, and considerable improvement in service efficiency. Nurses are empowered to play an essential role in co-ordination and patient communication. The telehealth concept will be developed as part of the future Smart Hospital model
