Authors (including presenting author) :
Wong SL (1), Fung SL (1), Leung KN, Sharron (1)., Wong LY, Melody (1)
Affiliation :
(1) Cardiothoracic Surgical Department, Queen Mary Hospital
Introduction :
Patient centered and team-based care are crucial in providing high quality and safe services. Clerical staff are part of the wider healthcare team and are essential in providing administrative and operational support. Engaging high performance clerical staff in team can greatly improves workflow and efficiency. Nurses have a key role in clinical environment including supervision in clerical operation. Thus, a nurse led quality improvement project is implemented to optimize practice flow and clinical efficiency through empowering team collaboration in ward.
Objectives :
To improve clerical workflow and team collaboration by redesigning clerical workplace and clinical operational process in ward.
Methodology :
The project was led by senior nursing staff who deeply understood the workflow and practices in ward. Problems in clerical workflow were identified through direct observation and structured interviews with nurses and clerical team. Then cross trainings were provided to clerks to get them familiar with the revamped workflow.
5S methodology was adopted to revamp the clerical facilities. Firstly, a separated clerk station with adequate spacing was set up. Then, the complicated clerical work is streamlined into multiple commonly performing tasks. Specific single task operating mini stations were set up accordingly in the clerical area. This action not only promoted clerical staff’ focus but also minimize distractions and error in their daily work.
Admission, in patient booking, discharge & general administrative mini stations were built with visual intuitive information. Discipline squares were applied to create equipment layout. Items were put together in functionality for better visual management and reducing likelihood of error. With such settings, nurses could easily and systematically categorize some important but non-urgent clerical tasks into corresponding mini station for clerical staff to follow-up.
Orientation on new clerical station and workflow were provided to both nursing and clerical staff. Nurse leaders would conduct regular round with clerks to ensure proper setting and sustainability.
Result & Outcome :
Retrospective interview with clerks and nurses was conducted after implementing the project. The new clerk station worked as a 24-hours communicating platform, coordinating patient’s activities in order and safely. 90% of our nurses agreed that the new station facilitated team collaboration and practice process in a logical and organized flow, especially in optimizing patient journey. Time lineless of care was improved by decreasing nurse’s time spent on searching around, seeking clerical support for non-urgent clerical tasks. Moreover, patient tasks could be performed in parallel rather than sequentially. Repetitive workload was reduced, which making nurses to have more time in patient caring. All clerical staff satisfied with the single task operating stations and agreed it improved tasks addressing capacity and flow accuracy. Tasks simplification reduced work complexity, tasks time and likelihood of error. One new clerk was hired after starting the project, he revealed the operation flow fostered his onboarding in focus, clarity and engagement. Conclusion: Building up clerk station with single task operating flow can optimize clinical work process, facilitate high performance team-based care and enhance clinical efficiency in ward.
