Authors (including presenting author) :
Wong WK (1)(2)(3)
Tong SWS (1)(2)(3)
Kwok CKP (1)(2)(3)
Fong YL (2)(3)
Law CH (1)(2)(3)
Au Yeung KL (1)(2)(3)
Tang HLH (1)(2)(3)
Fong Y (3)
Yan KH (2)
Affiliation :
(1) Ambulatory Care Centre, Tuen Mun Hospital (ACC/TMH)
(2) Specialties Out-patient Clinic, Pok Oi Hospital (SOPD/POH)
(3) Specialties Out-patient Clinic, Tin Shui Wai Hospital (SOPD/TSWH)
Introduction :
Over 100,000 referrals are received, handled and performed triage in the SOPC of our cluster per year. Our cluster consists of three hospitals (Tuen Mun Hospital, Pok Oi Hospital and Tin Shui Wai Hospital) which provide Orthopaedic (ORT) SOPC services. The waiting time for new cases among various hospitals in NTWC varies, so each patient was informed of the times and allowed to choose which hospital to be referred to. This led to great inconvenience and was risky as some referrals would have to be faxed time after time. Besides, the conventional new case referral handling and triage process in ORT/SOPC/NTWC involved lots of manual handling works, required large space for referrals storage, was time consuming and prone to errors such as delays in screening, missing referrals and wrongly sent/faxed items to the different relevant parties.
Objectives :
1. To replace the current referrals handling and triage process by developing a new web-based cross-hospital electronic triage system (E-Triage).
2. To allow doctors to perform triage without site restriction. This means that they can perform triage through the web-based e-triage system in their office, ward,etc… instead of only in SOPC.
3. To reduce the manual handling works for the referrals and their consumed times, such as photocopying, counting, sorting, referral handover, referral tracing, etc.
4. To speed up the referrals triage time
5. To minimize the space for storage of hardcopies of referrals and their handover records
6. To eliminate the risk of delay in screening referrals, missing referrals and errors due to fax/sending referrals
7. To provide training to related doctors, nurses and clerical staffs to use the new e-triage system
Methodology :
With support from top management, we liaised with the local IT team to develop a new web-based triage program (E-Triage program) which is cross-hospital and tailor-made for ORT/SOPC/NTWC. Multiple meetings were held to discuss and confirm the logistics of the referral flow in the system. Required hardware were arranged to be installed and prepared. Several drills with different scenarios were carried out to ensure the effectiveness and accuracy of the referrals flow among different hospitals. The new E-triage system was introduced to ORT doctors and trainings were given to related staff. Training materials and reminder cue cards were made for all users. The E-triage system commenced successfully on 3 May 2019. Even after the implementation of the new system, feedback was still continuously received from all users and adjustments were made according to user comments to further optimize the system.
Result & Outcome :
1. All the objectives were fulfilled.
2. 67% earlier (i.e. reduced from 3 days to 1 day) to perform triage by doctors.
3. 90 minutes (on average) saving per day for handling of the referrals by nurses
4. 26 users including doctors, nurses and clerical staff were invited to rate their satisfaction by the CSAT (Customer Satisfaction Score). The average CSAT of doctor was 4.7, nurse was 5 and clerical staff was 4.5 (maximum was 5)
5. The necessity of fax/sending the referral among hospitals was greatly reduced.
6. No missing of referrals and all the referrals are much trackable and traceable
7. With the use of E-Triage system, we can easily draw trends from a variety of statistics without manual interference.
