Authors (including presenting author) :
Chan MMO, Yik WM, Chan WLF, Choi KY, Ng SY, Fung MC, Leung SM
Affiliation :
Medical Day Ward, Princess Margaret Hospital
Introduction :
Quality improvement in healthcare is recognised internationally as a challenge. Optimization of care flow has a strong relation to reduction in patient waiting time for elective care. The daily patient load ranges from 60 to 90 cases with different treatments, which progress depends on the readiness of investigation and medication. This peak arrival rate not only confines patients and their relatives in a small waiting area exposing to higher infection risk, but also unnecessarily increases patient’s waiting time and affects service efficiency. Service hours utility diversion enhances efficient service delivery and patient safety.
Objectives :
(1)To reduce case overload in peak service hour; (2) to maintain service efficiency by diversion of admission time; (3) Ensure optimize infectious control standard is provided.
Methodology :
Currently more than 95% of daily patient admissions are congested between 08:30am to 09:30am, diversion of admission time enhances service hours’ utilization and minimises patient stay in the same time slot. Operation workflows for different types of patients were carefully analysed to identify treatments having highest feasibility with minimum cost for diversion of admission time. Subcutaneous chemotherapy and bronchoscopy were selected as pilots and admission time was diverted to later session from May to December 2020.
Result & Outcome :
Total of 1700 cases of subcutaneous chemotherapy and 130 cases of bronchoscopy were screened. 896 (53%) and 130 (100%) cases were diverted to afternoon and late morning session respectively. This new arrangement successfully reduced the average waiting time for bronchoscopy by 2.5 hours and the average waiting time of other patients in the early morning session by 10 to 20%. Besides, the average number of people in Day Ward during peak hour was reduced from around 110 to 90, which was about 40% decrease in excessive percentage, assuming normal capacity of Day Ward is 60. Conclusion: By diversion of patient admission time, congested situation can be improved and service efficiency can be enhanced, which benefits both diverted patients and un-diverted patients in terms of waiting time and treatment environment. Better infection control, which is critical under existing Coronavirus pandemic, is also addressed. Further study is planned to optimize other workflows, aiming to maintain the quality of service and get prepared for the increasing needs from the public.
