Authors (including presenting author) :
LEUNG YY(1), Kan PG(1), CHAN YNP(1), LAU SKJ(1), YU WTC(1), Man MY(1), SUNG HLH(1), SZETO YP(1), CHIN MT(1), LEUNG CP(1) ,TONG YHA(2), WONG W(2), YU W(2), KWONG YOE,(2) LI CFR(2),LUI CT(3)
Affiliation :
(1)Accident and Emergency Department, Ruttonjee & Tang Shiu Kin Hospitals, (2)Hospital Authority Head Office Information Technology, (3)Accident and Emergency Department, Tuen Mun Hospital
Introduction :
Infusing the urgent service with innovative technology not only can provide higher quality service, as well as enhance patient safety. eAED is a major initiative under SMART ED, through this electronic platform, AE record can go electronically. This can provide accurate, timely, and complete patient information as well as reduce medical error and enhance efficient. How to transform an operating emergency department from traditional paper record to electronic is a challenge.
Objectives :
1. To cultivate an embracing change culture to facilitate smooth transformation to SMART ED.
2. To improve patient safety, quality service and clinical workflow.
Methodology :
Unfreeze:
First, get top management support, then liaise with Hospital Authority Head Office Information Technology (HOIT) team to had site visit and confirmed Ruttonjee and Tang Shiu Hospitals A&E Department (RTSKHA&E) suitable for launch eAED project. Promulgate eAED in various A&E meetings, nurse handover and emails to let colleagues install the mindset they are shaping the future. Fostered an embrace to change culture, colleagues proud to and felt need to change. To address staffs’ doubts and concerns, organized A&E visits to Tin Shiu Wan & North Lantau Island Hospital A&E department where eAED already implemented. Invite informal leaders as workgroup members to facilitate change.
Change:
Engaged frontline staffs to design future clinical workflow, all of them realized that they were making things differently. A&E record form resigned to smooth workflow communication. Additional CMS workstations were installed to facilitate clinical operation. Developed an eAED manual to standardize clinical workflow and for staff reference. HOIT colleagues organized eAED training sessions to ease A&E staffs’ anxiety and uncertainty. A local training team established to provide intensive training to all staffs. Rapid communication channel linked up with HOIT team for promptly solve IT related problems. Collaborate with HOIT colleagues organized workflow drills and cross department drill to ensure smooth operation in live run.
Refreeze:
Additional manpower deployed to triage station to soothing staff’s pressure in initial implementation stage. Two cerebration meetings held to review and modified the workflow after implementation.
Result & Outcome :
With the support of HOIT, RTSKH is the first operating A&E implemented eAED on 29 May 2019. Staffs willing to join IPMOE in A&E and CQMS project under SMART ED. Conclusion Facing of increasing service demand, ED modernization is needed to improve efficient and patient safety. A successful change need top management support while sustainable change need frontline abutment.
