Enhancing the Efficiency and Accuracy of Vital Signs and Point-of-Care Tests Data Capture in Accident & Emergency Departments

Abstract Description

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Authors (including presenting author) :

Yu WMW (1), Tong YHA (1), Wong WYW (1), Lau KK (1), Li CF (1), Chan HS (1),Kwong YO (1), Cheung NT (1)

Affiliation :

(1) Information Technology and Health Informatics Division, Hospital Authority Head Office

Introduction :

In view of shortage of health care providers and increasing numbers and complexity of Accident & Emergency (A&E) attendance, the waiting time in A&E advanced over the decade. The development of simplified A&E clinical electronic documentation intends to facilitate the clinical workflow and accuracy of vital signs and Point-of-Care Tests (POCT) data capture by various health care providers, especially nurses and health care assistants (HCAs). Nurses can spend more time on patient care and clinical decision making rather than being a “typewriter”, while HCAs are able to capture the clinical data in a faster way which promotes the communication process in A&E. The ultimate goal is to cut down on the waiting time in A&E and to improve the clinical service.

Objectives :

This essay aims to explore the effectiveness of developing simplified A&E electronic clinical documentation to the efficiency and accuracy of vital signs and POCT data capture in Accident & Emergency Departments.

Methodology :

A Proof-of-Concept (POC) of simplified clinical electronic documentation is designed as a function in Clinical Management System (CMS). The data scope of such POC consists of but not limited to Vital Signs – body temperature, blood pressure, pulse/heart rate, oxygen saturation in blood, respiratory rate, Glasgow Coma Scale, visual acuity and intra-ocular pressure; while POCT includes body weight, body height, urine test (including pregnancy test), blood glucose, and hemoglobin. The POC is proposed to implement not only in desktop CMS station but also in mobile device – Tough Pad. Enlarged fonts, descriptive icons, and simple screen flows are used in the POC which promotes user experience when interacting with the system. The risk of patient misidentification can also be reduced by patient checking before documentation.

Result & Outcome :

The POC will be rolled out to existing A&Es using clinical electronic documentation (eAED) in the 2nd quarter of 2019. Improvement in user experience, enhanced patient identification and reduced waiting time in A&E would be expected after the learning period of the new system. Further validation is needed after implementation.