Authors (including presenting author) :
S M SUEN, PMH DOM(Neuro & ICC)
Candic TANG, PMH DOM(Med&Geri)
Affiliation :
Information Technology Department, Princess Margaret Hospital
Patient Care Process Workgroup, Princess Margaret Hospital
Introduction :
A comprehensive clinical handover prevents patient harm from missing of transfer of information and enable continuity of care for the patient during hospitalization. Patient Clinical Hanover System (PCHOS) is a system designed in Princess Margaret Hospital to facilitate effective clinical handover with necessary information about the patient being cared and communicated. SBAR (Situation, Background, Assessment, and Recommendation) format was adopted in the system to facilitate effective communication among teams with standardized model. The incorporated care plan in the system also allowed staff to use the shared information for preparation of tailor-made patient care plan on coordinating patient daily care and reducing risk of missing information on care. In addition, the automatic CNS case referral of the system had saved nursing time markedly and transferred the necessary information to designated healthcare team synchronously.
Objectives :
Developed a comprehensive, effective and well-uniformed system for daily clinical handover Standardized Situation, Background, Assessment and Recommendation (SBAR) template to facilitate communication among staff
Enhanced continuity of nursing care Reduced risks on missing patients care e.g. Missing of patient appointment, infection control
Provided guidance to junior staff and new comers Enhanced staff ownership and participation on care planning
Regulated and generated clinical forms from the system for substitution of existing manual forms
Generated the necessary data to electronic whiteboard for information sharing Initiated consultation to other specialties such as CNS without duplication of information submission. Diminished nursing workload on documentation
Methodology :
The electronic PCHOS system changed the format of clinical handover from Paper Format to Digital Record System and allowed staff to tailor-made the individual patient care plan daily. It enhanced staff ownership and assisted them to maintain the ongoing of care to the patients. With the development of self-Managed, Least-Admin Web Platform, it supported different clinical departments for using the system to reduce the risk of dis-continuity of patient’s care. The system also supported the information transfer with same hospital number which reduced duplication of information submission. In addition, the standardized care plan template serves as guidance for the junior staff and newcomers to ensure safety of care. The Automatic CNS case referral function also changed the format on case referring to other healthcare professional team. It provided a paperless electronic platform for accurate information transfer without additional workload of staff.
Result & Outcome :
The program was piloted in Neurosurgery and Medicine & Geriatrics Department in October 2017 and was well accepted by frontline staff. The program was then rolled out to other departments with fully implementation (except Intensive Care Unit) in PMH. Its acceptability and flexibility were proved again while the program was adopting in psychiatric setting of Kwai Chung Hospital and rehabilitation setting of Lai King Convalescent wards in 2018. Their iPad friendly design also facilitated the handover in paperless format. According to PCHOS statistic from 6 October 2017 to 23 November 2018, total number of PCHOS users is 1,507 in 114 wards, number of CNS referrals is 2,396 and total 73,600 Hospital Cases were handled with 1,610,000 transactions. Time used in Nursing Handover & CNS Referral Process after using PCHOS was reduced significantly by 12,267 Hours (Save 10 minutes/HN). A hospital wide evaluation survey has been done in August 2018 with 73 surveys received, the mean satisfaction score is 3.19 (2.68 – 4.88). High correlation with the overall satisfaction was found in the facilitation of daily clinical handover (0.91), enhanced consistency of nursing (0.89) and providing guidance to junior staff and new comers for identifying patient’s care focus and clinical handover (0.82)
Co-location with:
