Authors (including presenting author) :
Lit MPK(1), Ng CK(1), O WH(1), WK Tang(2), Yim CW(2), Chiu CF(3), Ng, TT(3), Choi PMP(3), Ling SO(2, Chan WMJ(1)
Affiliation :
(1) Respiratory Division, Department of Medicine, Queen Elizabeth Hospital (2) Department of Respiratory Medicine, Kowloon Hospital (3) Department of Electrographic Diagnostic Unit, Queen Elizabeth Hospital
Introduction :
Obstructive Sleep apnoea (OSA) is common in HK which account 2% of middle-aged women and 4% of middle-aged men in Hong Kong. Polysomnography (PSG) remains the gold standard diagnostic test while Continuous Positive Airway Pressure (CPAP) therapy is the corner stone treatment for OSA. However, the service differentials are observed in new case triage criteria, PSG and CPAP waiting time and booking system
Objectives :
To review the efficacy and effectiveness after implementation of inter-hospital collaboration sleep services programs
Methodology :
Cross-hospital access of Electronic Patient Record (EPR) and electronic appointment booking arrangement was set up in May 2018 with inter-hospital and inter-departmental collaboration including respiratory specialty, electrographic diagnostic unit, Information Technology department between KH and QEH. The sleep service workflow and logistic including triage criteria, treatment priority and category standardization between KH & QEH were formulated. A total of 24 quotas of sleep study appointments in each year will bereleased both from KH and QEH. CPAP titration will be performed at the same hospital after sleep apneas confirmed by PSG. Phone call reminder will be given to ensure attendance few days to 1 week before PSG appointment. Patient will be referred back to parent hospitals for subsequent follow-up within 1-2 weeks. The PSG & CPAP titration report will be sent back to designated respiratory nurse of respective hospitals.
Result & Outcome :
The inter-hospital sleep services were started since August 2018 to enhance uninterrupted urgent PSG services during renovation period from August to November in KH. Mutual cross booking services was finally implemented in December. This is an over one-year review from August 2018 to October 2019. A total of 8 PSG and 6 CPAP vs. 24 PSG and 16 CPAP were booked through the electronic Patent Administration System from KH & QEH respectively. The mean waiting time of elective PSG were increased 7% (285.5 weeks) and 33.2% (77.71 weeks) in QEH and KH respectively. The average waiting time for urgent PSG were significant improved with 55.7% (5.8 weeks) in QEH and 61.7% (1.84 weeks) in KH. Both mean elective and urgent CPAP waiting time were markedly reduced to 87.8% and 63.8 % in QEH (23.1 vs 2.8 weeks and 5.8 vs 2.1 weeks) whereas 80.7% and 57.6% in KH (14.5 vs. 2.8 weeks and 3.3 vs 1.4 weeks) Conclusion:The inter-hospital sleep services enhance significant reduction in waiting time of elective CPAP, urgent CPAP and PSG. However, the demand for elective PSG is still increasing, corporate sleep service annual plan bid and further collaboration with Wong Tai Sin Hospital within same cluster may meet the high demand services.
