Authors (including presenting author) :
HO KM,Law TC,HO CP,Lau SH,Leung KH,Leung SH,Li YC
Affiliation :
Kowloon Central Cluster Department of Family Medicine and General Out-Patient Clinics
Introduction :
Following the action plan of Hospital Authority, the boundary of Kowloon Central Cluster(KCC) was redefined in 2016. Seven General Out-Patient Clinics(GOPC) were reallocated from Kowloon West Cluster(KWC) to KCC. How to integrate two different teams and upkeep the quality of patient care poses a big challenge. This article aimed to describe the methods and steps adopted by the Risk Assessment and Management Program-Hypertension(RAMP-HT)team of KCC FM & GOPC to ride on this challenge and turn it into an opportunity to strive for better care in hypertensive patients.
Objectives :
The objective of the program is to enhance better hypertensive patients care through alignment of RAMP-HT in both teams after re-clustering
Methodology :
KCC FM&GOPC Merging Integration Working Group(MIWG) has hold meetings regularly to review and align RAMP-HT services in both teams(Ex-KWC Clinics and Original KCC Clinics) since November 2017. The meetings involved department COS,consultant,DOM,Merging Integration Coordinators(MIC) and both teams RAMP HT Coordinators. The meetings reviewed and discussed the operation differences and service quality control between both teams. Operation differences have been discussed includes:
1)Services quota
2)Nursing services(Hypertension Complication Screening(HTCS) referral criteria,credentials and contents)
3)Clinic blood pressure machine validation workflow
4)Home blood pressure machine validation workflow
5)Clinic blood pressure data entry workflow
6)Protocol for handling patients with white-coat hypertension of hypertension with white coat effect
7)Ambulatory Blood Pressure Monitoring(ABPM) arrangement including booking workflow
8)ABPM machine setting, service contents etc
9)Physiotherapy service support Service quality control discussed includes:
1)HTCS audit protocol
2)Hypertension Individual Nursing counselling(HTNI) audit protocol The meetings aimed at the alignment for the best practice to enhance hypertension patients care in KCC FM&GOPC. In order to standardise the RAMP HT, Revamp HT RAMP roadshows had been hold in all clinics promulgate the agreed and aligned RAMP HT services. The roadshows promulgated the importance of quality hypertension control to our patients’ health,the aligned RAMP HTCS services,the accurate application of Joint British Society II(JBS II) Cardiovascular Risk Calculator,the indications of ABPM and aligned ABPM workflow,the aligned patients clinic BP entry workflow,the workflow of handling of patents with white coat hypertension and hypertension with white coat effect,the RAMP HT service audit and the standardise RAMP HT documentations.
Result & Outcome :
The KCC FM&GOPC RAMP HT services have been aligned with standard workflow and documentations.
The Key Performance Index(KPI) of the percentage of HT patients under control in both teams has been reviewed regularly. The KPI of ex-KWC clinics showed marked improvement from 76.1%(16Q4) to 82.3%(18Q3). The BP capture rate has been maintained at around 99%(HA Overall 99.3%).
Co-location with:
