Authors (including presenting author) :
Siu S Y , Wong Y M, Wong W C, Ho W Y, Tam W S, Law K W
Affiliation :
Ophthalmology,TWEH
Introduction :
The demand for ophthalmic out-patient service was growing constantly in Hong Kong East Cluster. In the past, patients who wished for a consultation before their scheduled appointments had to register as “walk-in” cases and needed to wait for a couple of hours before knowing whether they would be seen by the doctor. To improve satisfaction of stakeholders as well as to ensure service quality and patient safety, a new nursing triage service for walk-in old cases was developed.
Objectives :
1. To develop an old case nursing triage protocol
2. To ensure patients receive appropriate care by undergoing nursing triage process
3. To reduce workload related to handling of walk-in cases from registration, medical record tracing and consultation
4. To improve staff satisfaction by delivering care in an efficient and effective way
Methodology :
A new nursing triage service for walk-in old cases was launched since 1/7/2018. Patients were required to hand in a valid referral, and triage nurse would provide appropriate assessment with a step-by-step approach. Appropriate triage category was assigned according to guideline, and doctor would be consulted if in doubt. Appointments would be vetted by doctor at the end of consultation session.
A questionnaire was used to evaluate staff perspective towards the new service.
Result & Outcome :
Average monthly walk-in cases dropped rapidly from 150 to 32 after implementation of new service.
Nursing triage is efficient and effective as only 1.5% of triaged category was amended by doctors.
32 questionnaires from doctors, nurses and ECAs were collected. All staffs agreed with decreased workload and increased smoothness of daily consultation. 89% of nurses agreed that streamline the work process helped them to deal with extra triage workload. 93.8% of staffs agreed that reforming walk-in service was appropriate. Furthermore, no patient complaint was received since implementation reflected patient’s satisfaction towards the new service.
This program decreased heavy workload related to handling of walk-in old cases. Quality and safety of triage process was guaranteed and patients could receive appropriate care by undergoing the triage process. Staff expressed satisfaction towards the new triage system. Resources of public health sector could be properly and effectively utilized. Triage guidelines should be reviewed regularly to ensure service quality and patient safety.
