Authors (including presenting author) :
Lam YC(1)
Affiliation :
Accident and Emergency Department, Tseung Kwan O Hospital
Introduction :
Waiting time of Category 2 cases from November 2018 to October 2019 was reviewed. 5 months of the above period could not meet the HA KPI. 69 out of 1318 (about 5.23%) category 2 cases' waiting time were longer than 15 minutes. The focus of this project was to minimize the number of ambulatory category 2 cases’ waiting time longer than 15 minutes during the non-meal break time or night shift.
Objectives :
To shorten the consultation waiting time of A&E Category 2 Cases
Methodology :
Analysis was done among all 69 category 2 cases with waiting time longer than 15 minutes. 37 cases (54%) happened during the meal break or the night shift. The overall manpower during these periods of time was thinner than the rest of the day and it is very difficult to further shorten the waiting time under the current condition. From another perspective, 84% of all out ranged cases were walk-in cases. Among these cases, the 5 most common diagnoses were shortness of breath, post-chemotherapy fever, arrythmia, drug overdose or suicide cases and complicated pregnancy. A meeting among A&E specialists and nurses was held and strategies were set to meet the objective. All A&E nurses were briefed of the above case review findings and recommendations during handover, such as the common scenarios of over-triaged case. Triage exercise with individual feedback was given to all nurses to enhance triage accuracy. A roller banner was set up at the waiting hall with specific conditions that remind patients to approach nurse sooner before triage. Prompt alert would be given to all the doctors and nurses about the arrival of Category 2 cases by the use of public announcement system. For walk in cases, doctor would be alerted by the triage nurse and asked for early intervention.
Result & Outcome :
Among 211 category 2 cases in December, only 2 cases' waiting time were longer than 15 minutes. (0.9% of all category 2 case) The effectiveness of the strategies would be further monitored in the coming 6 months and 12 months' time.