Authors (including presenting author) :
Wong CL(1), Chan SW(1), Ng YB(1), Sim TC(1), Sha KY(1)
Affiliation :
(1)Department of Medicine and Geriatrics, United Christian Hospital
Introduction :
During the winter surge period. The huge bed occupancy in the medical wards is the big challenge in United Christian Hospital (UCH). The convalescent hospitals in Kowloon East Cluster (KEC) play an important role in helping patients through acute to extended care and from hospital to community. However, the long waiting time for the convalescent care lead to congestion in wards. It not only driving dissatisfied patients and families, but also increased the health care costs. In order to reducing waiting time and length-of-stay in acute care setting, the Rapid Assessment and Early Discharge Planning strategic were implemented since December 2017.
Objectives :
This project aimed to triage patients who are priority for convalescent unit admission to enhance the utilization of convalescent bed usage, and shorten the length of stay in acute care unit.
Methodology :
By early recognition and assessment of patients’ condition, the triaging method is used. Two senior nurses were assigned as the triage nurses, who have completed a series of training, including health assessment and history-taking skills. They also have good connections with local primary care and community services. The team adopts a triage system. A standardized assessment form was designed. It helps to triage the suitable patients effectively and expedite safe and rapid discharge for them. The high priority convalescent bed are offer to the elderly patients, who suffers from the specific illness or health conditions, including falls, dementia, severe low back pain and respiratory system related diseases. On the other hand, if the patients have a frail community support. They would be referred to adequate services, such as Integrated Care and Discharge Support for Elderly Patients (ICDS), Home Support Team (HST), Community Nursing Service (CNS) and other Non-Government Organizations (NGO). The team also liaises with SOPD and GDH to offer early appointments for the special cases.
Result & Outcome :
This Rapid Assessment and Early Discharge Planning project implemented from 1 December 2017 to 31 May 2018. During the intervention period, there were 1134 patients who are waiting for the convalescent bed in the KEC booking list. 6.4% of the patients (n = 73) in the list were conducted the rapid assessment and discharge planning by the triage nurse. 43.8 % of the target patients (n = 32) were prioritized to the convalescent bed after rapid assessment. The median waiting time for convalescent bed was 3.8 days. Meanwhile, 52.6% of the target patients (n = 41) were sorted out from the waiting list. They could be discharged to community directly with adequate support. Total 16 patients (21.9%) were referred to ICDS Case manager for disease management. Four patients (5.4%) were supported by NGO services. Ten patients (13.7%) were referred to Enhanced CNS after hospital discharge. 12.3 % (n = 9) of patients were arranged early medical follow up appointments. Although patient satisfaction surveys were not performed in this program, the team received appreciations from the patients and clinical staff.
Co-location with:
