From access block to smooth admission

PWH Service Accessibility Improvement Team (The Block-buster Team)
Prince of Wales Hospital

Under the AED Flu-monia Programme, influenza and or pneumonia patients with stable conditions receive appropriate treatment at AED.

Six years ago, there was a tough access block issue at the Accident & Emergency Department (AED) of Prince of Wales Hospital (PWH) caused by the ever-increasing service demand and limited bed capacity of PWH. Some patients had to wait for more than 72 hours while over a thousand patients waited for more than 24 hours at AED before admission to inpatient wards. Determined to improve this undesirable situation, Dr Lo Su-vui, Cluster Chief Executive of the New Territories East Cluster, formed the Block-buster Team with full support of the Central Nursing Division. Through implementing a series of systematically planned measures by pooling the resources of various departments, the team succeeded in alleviating the access block issue in a holistic way over the past few years. From July 2019 to June 2020, over 90% of the AED patients were admitted to inpatient wards within four hours.

Morning checkup to clear access block

The Block-buster Team has introduced a proactive bed management system whereby designated bed coordinators will, commencing 7:30am every morning, closely monitor and quickly screen AED waiting cases regularly to make bed arrangement for patient admission. When the medical wards with about 500 beds are full, patients will be triaged and arranged to other wards to maximise bed usage.

Cultural change

The Block-buster Team has taken the lead to change the mentality of ‘mind your own business’ to the culture of ‘when trouble comes at one spot, help comes from all quarters’. This new culture helps to maximise usage of the scarce bed resources for the benefit of patients.

Measures for minimising hospital admissions

• The AED Flu-monia Programme: influenza or pneumonia patients with stable conditions are discharged home after receiving appropriate treatment at AED, to be followed up by community outreach service teams or the AED Nurse Clinic.

• The Geriatric at AED Front Door Scheme: elderly patients are attended to and triaged by geriatricians stationed at AED for direct transfer to Shatin Hospital to receive appropriate treatment and rehabilitation.

The Block-buster Team leader, Dr Cheung Nai-kwong, Deputy Hospital Chief Executive (Operations), says, “The access block issue not only delays patient treatment thus affecting clinical outcomes, it can also generate complaints and undermine staff morale. For this reason, we will continue to make strenuous efforts to shorten the waiting time for admitting patients to hospital wards.”

Team list