Authors (including presenting author) :
Yeung WWK(1), Lau RWH(1), Tsang RSW(2), Tse KY(3), Tong J(1), Fong PWK(2), Lo DKL(1), Chui ST(1), Ng CSH(1), Wan IYP(1), Wong RHL(1), Underwood MJ(1), Siu EHK(2), Tsung PPK(3)
Affiliation :
(1) Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital (2) Department of Physiotherapy, Prince of Wales Hospital (3) Department of Anesthesia & Intensive Care, Prince of Wales Hospital
Introduction :
Prince of Wales Hospital (PWH) is one of the three designated centers in providing cardiothoracic surgical service in Hong Kong, in which over 300 thoracic operations were performed in 2018. Due to the fast-growing of healthcare demands and patient expectations, the existing service model may not able to overcome those challenges in the near future. Therefore, the current patient workflow was reviewed and redesigned.
Objectives :
- To reduce hospital stay by redirecting patients to out-patient setting for operation preparation. - To vacate in-patient bed for patients who are in need, e.g. emergency admission and peri- operative care.
Methodology :
A once-a-week cardiothoracic nurse clinic (CTNC) session was started for pre-operative thoracic patients since October 2018. Patients with suitable condition, instead of admitting them to cardiothoracic ward one day before surgery, they were redirected to CTNC, Pre-Operative Anesthetic Clinic (POAC) and out-patient Physiotherapy Department 1-2 weeks before the operation for pre-operative preparation. Patients’ condition and readiness for surgery was reviewed by responsible nurses and discussed with surgeons if necessary. With all completed preparations, patients were able to be admitted to cardiothoracic ward or Day Surgery Center (DSC) on the day of surgery.
Result & Outcome :
From October to December 2018, total 32 patients were referred and completed the pre-operative preparation according to new patient workflow. 27 (85%) of them successfully underwent same-day admission and received the planned operation accordingly. Thirty-five hospital bed days were saved during this period. Average length of stay for elective thoracic surgery reduced from 6.27 days to 3.4 days (45% reduction). To conclude, the new patient workflow was able to reduce hospital stay by redirecting patient to out-patient setting for pre-operative preparation.
Co-location with:
