Authors (including presenting author) :
Kwok CKP(1), Wong SYC(1), Tong SWS(1), Tang HLH(1), Wu KYT(1), Wong WK(1)
Affiliation :
(1) New Territories West Specialist Outpatient Clinic (SOPC)
Introduction :
It is unavoidable to make phone contacts to patients to do simple drug dosage adjustments in Specialist Outpatient Clinic (SOPC) for abnormal blood test results. There were incidents in which patients claimed that they did not receive messages about medication adjustments. A pilot has been started in Medicine & Geriatrics Clinic (M&G) in Tuen Mun Hospital Ambulatory Care Centre since 17 December 2018.
Objectives :
1. To provide a formal communication channel to remind patients about drug dosage adjustments
2. To document communication process electronically
3. To enhance ambulatory drug dosage adjustment workflow
Methodology :
Workflow, disclaimer and Short Message Service (SMS) messages were developed in collaboration between SOPC nurses and M&G doctors. The proposal was supported by cluster SOPC committee, Quality and Safety Department and Department of M&G. Disclaimer has been posted at the registration counter to announce our initiative. A three-hour training session was given to SOPC nurses before implementation in October 2018. If patients require drug dosage adjustments, doctors must document actions in Clinical Management System (CMS) clinical notes. Then nurses would phone contact patients or caregivers for the drug change immediately. Finally, SMS messages would be sent to concerned patients (or caregivers) after phone calls and nursing actions would be documented in CMS nursing notes. SMS would also be sent to patients when they could not be reached by phone. Three standard messages were created. One type of message was sent to patients whom they could be contacted to document the action o
Result & Outcome :
By 6 January 2019, eighteen calls have been managed by the new logistics. Eighteen patients were contacted to stop medication. All were on warfarin and were found warfarin overdose during blood result screening. Two patients had appointments advanced and the rest were followed within three days as scheduled. This enhanced logistics appear to be promising and safe. All patients, doctors and nursing staff involved appreciated the outcome. The logistics has a potential to extend to other type of clinical actions at SOPC.
Co-location with:
