Authors (including presenting author) :
YEUNG P H (1), LO B Y E (2), LAM Y F (2), HUI T P B (1), CHAU L T C (1)
Affiliation :
(1)Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, Hong Kong
(2) Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong
Introduction :
During the winter surge, medical inpatient beds occupancy rate is always over 100%. Lack of beds is the major challenge in acute medical wards. Both patient admissions and discharges consistently peaked at the same period of the day (12 noon to 5pm). Patients have to wait more than an hour for the inpatient beds. High bed occupancy rates caused of crowding environment and clinically unsafe. A Discharge Lounge (DL) started implementing as pilot program in Department of Medicine in PYNEH since 2018. The concept behind was to facilitate inpatient beds turn over, decongestion of ward crowding and streamline workflow of pick-up discharge patients to NEATS.
Objectives :
To assess the DL can improve wards crowding and facilitate the discharge efficiency during winter surge
Methodology :
Location of DL was set up at ground floor and accommodated maximum 8 patients at a time. Operating hours of DL was from 11am to 5pm weekdays (except holidays) during Jan to Apr in 2018 and 2019 supported by the DL team including one part-time nurse, two part-time supporting staff and one full-time APN from Nursing Services Division. DL team had arranged the eligible patients to DL once they were READY for the NEATS. Patient’s education, quality of nursing care and nutritional supports were continued while waiting for the NEATS. Dural channel referral was implemented in DL including by DL nurse daily screening and ward nurses proactive updated patient’s READY status via phone. A survey was conducted to evaluate the effectiveness of DL services during the winter surge.
Result & Outcome :
The DL service significantly facilitate the discharge efficiency in Department of Medicine.In future, DL would be reopened annually in winter surge in the hospital. A total of 295 patients and 892 patients stayed in DL with average 4.3 and 12.0 attendances per daytime in 2018 and 2019 respectively with significantly increased in 2019. Nearly 28.9 % and 66.5% of eligible patients had arranged to DL in 2018 and 2019 respectively. Beds turn over had been increased, and on average within 30-90 minutes from the time a READY status was confirmed and arranged to DL. Besides, the survey had succeeded in obtaining 112 questionnaires from inpatients wards. 89% respondents agreed DL service could be relieved congestion during winter surge, 75% respondents agreed DL service could enhance discharge efficiency and most importantly, 92% respondents agreed the DL service was useful.
