Thinking from a patient’s perspective

Lee Kwok-hung
Nurse Consultant (Department of Accident & Emergency) Prince of Wales Hospital

Nurse clinics are common in Hong Kong today, but they were a new concept a little over a decade ago. Lee Kwok-hung, Nurse Consultant in the Department of Accident & Emergency (A&E) at Prince of Wales Hospital (PWH), says new and improved service models are driven by patients’ needs and insists: “There is no ‘best’ – only better.”

Kwok-hung was sent to Oxford in the United Kingdom with a colleague in 2006 for nine months to study ways to deal more efficiently with minor injuries, and helped set up Hong Kong’s first A&E nurse clinic at PWH when he returned. Nurses in the clinic deal with patients with minor injuries, such as fractures, dislocations, and injuries that require a cast or stitching. Patients are attended more quickly and the clinic has received positive feedback since it was set up.

“It reduces the waiting time of patients as well as the pressure on A&E, which creates a win-win situation,” Kwok-hung observes. Nurses concentrate not only on the injury or illness itself but also the living environment of the patient, so they are able to tailor discharge plan. The clinic provides a one-stop service where possible, including assessment, investigation, follow-up appointment and referrals.

Nurses who learn more advanced skills can help more patients and be rewarded with greater job satisfaction, Kwok-hung argues. “The power of one person is limited,” he says. “If more colleagues acquire nursing skills, more patients will benefit.” To enhance service standard and pass on expertise, Kwok-hung regularly organises training courses on stitching, abscess drainage, triage, reduction and other skills.

Kwok-hung also thought up a way to ease the pressure on A&E during winter surge when long queues of patients wait for admission. He proposed prescribing medication to patients assessed for minor conditions, allowing them to have appropriate treatment and X-ray examinations in nurse clinics where needed, thereby relieving pressure on hospital beds and doctors. “You can understand a patient’s needs when you put yourself in his shoes,” Kwok-hung remarks.