Authors (including presenting author) :
Wong KW(1)(2), Lee SL(1)(2), Kwok TK(1)(2), Hui LF(1)(2), Cheung PL(1)(2), Maw C(3), Tang KS(4), Li T(5)
Affiliation :
(1) Quality & Safety Department, Hong Kong West Cluster, (2) Hong Kong West Cluster Inter- / Intra-Hospital Patient Transfer Working Group, (3) Grantham Hospital / Tung Wah Hospital, (4) The Duchess of Kent Children's Hospital / TWGHs Fung Yiu King Hospital / MacLehose Medical Rehabilitation Centre (5) Hong Kong West Cluster / Queen Mary Hospital / Tsan Yuk Hospital
Introduction :
Patient transfer is a common and frequent clinical practices within hospital and inter-hospitals. Hong Kong West Cluster Inter- / Intra-Hospital Patient Transfer Working Group was set up in June 2017 to oversee the patient transfer related activities within Hong Kong West Cluster (HKWC), and to ensure effective and safe patient transfer across HKWC hospitals.
Objectives :
To develop policy, guidelines and indicators related to inter-hospital / intra-hospital patient transfer in HKWC hospitals and evaluate the transfer process.
Methodology :
- Four foci were identified, including handover, medications, critically ill patients and non-emergency ambulance transfer service, and sub-workgroups were set up to discuss the above issues in details.
- Chairperson, secretary and quality and safety colleagues paid visits to each individual department to understand the patient transfer journey, their current practices, concerns and feedback towards the Hospital Authority Head Office Guidelines on Intrahospital Transport of Critically Ill Adult Patients.
- With reference to the Hospital Authority Head Office Guidelines on Intrahospital Transport of Critically Ill Adult Patients, developed the guideline for HKWC.
Result & Outcome :
- The HKWC Guidelines on Interhospital / Intrahospital Transport of Critically Ill Patients (Exclude Neonates) was developed, endorsed by cluster management and implemented on 1 December 2020.
- Standardised the Patient Transfer Note, Checklist and Documentation for Interhospital Transport of Critically Ill adult and paediatric patients, with necessary information (e.g. tracheostomy status, permanent / temporary) to ensure patient safety and facilitate communication/handover.
- Capnometers and hand-held suction machines were procured for patient transport if indicated.
- Standardised using FX-size oxygen cylinder with build-in regulator for patient transport together with practical tips developed.
- Medication transport workflow was reviewed to ensure patient has sufficient medication after transfer, with fewer incidents were reported.
- Number of cases with late arrival to cluster hospitals were decreasing by reminders in medical wards to alert doctors to handle the cases with priorities, enhanced non-emergency ambulance transport service with additional accessible hire cars support.
In conclusion, patient transfer is a clinical practice which involves multiple stakeholders. The effectiveness, efficiency and safety rely on all parties to comply with the policy, guideline and workflow. An audit will be conducted to monitor the compliance.
