Authors (including presenting author) :
LEE H(1)(3), Wong A(2)(3), Ng KF(2)(3), CHING KM(1)(3), Nutritional Management Team(3)
Affiliation :
(1)Dietetic Department,(2)Food Services Department,(3)Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Patient’s enteral formulas prescription was ordered through Dietetic and Catering Management System (DCMS). There was a high volume of surplus formula return to Food Services Department (FSD) every day. It created excessive stock management work; e.g. recording, carrying and lifting effort for wards and FSD staff. Dietetic Department, FSD and the Nutritional Management Team met and discussed this issue. The root causes were identified: 1. Patients prescribed with ‘Nil by Mouth’ were not updated into the DCMS. 2. Upon admission, most patients were prescribed with a lower strength and smaller formula volume of their DCMS record.
3. When patients started tube feeding, the previous oral supplements ordered in DCMS were not deleted.
Thus, DCMS would prompt FSD to deliver a surplus volume of formula to wards.
Objectives :
To reduce the volume of the surplus enteral formula and ensure wards receive a sufficient quantity for patients’ consumption.
Methodology :
1. Number for each type of return surplus enteral formula was recorded for one year. 2. The collected data was used to project an estimated critical volume of enteral formula provision to wards. Trial run was commenced in mid-January 2018.
3. Dietitian rewrote the stock management guideline for enteral formula for FSD. New guideline commenced in use in mid-January 2018. 4. FSD redesigned a system for wards to temporary suspend enteral formula delivery. New system commenced in January 2018.
5. An education class was provided to nursing staff to review DCMS ordering on 12 July 2018.
Result & Outcome :
The number of surplus enteral formula returned to FSD was 3816 packs per month from January 2017 to January 2018. After the implementation of changes in mid January, the number of surplus was 3311 packs per month from February to October 2018. There was a 13.2% reduction of the surplus formula. Better stock management reduces work load for front line staff and minimize the risk of injury at work place. This is a continuous quality improvement project, ongoing review is necessary to produce a further reduction in the future.
Co-location with:
