Hats off ...... to winners of the Outstanding Staff and Teams Award 2013

The Outstanding Staff and Teams Award 2013 ceremony recognises six outstanding members of staff and five outstanding teams for their excellent performance, as well as the admirable efforts of the merit award recipients.

Outstanding Staff

Chan Lai-hung	Dr Lau Pui-yau
Anna Mak Suk-han	Kenneth Shum Lai-him
Kitty Siu Kam-sau	Oliver So Wai-sang

Outstanding Team

Clinical Data Analysis and Reporting System (CDARS) Team	Health Care Food Service Team
Hong Kong Buddhist Hospital Joint Replacement Centre	Kowloon East Cluster Cataract Consortium
NTEC Medication Safety Enhancement Team (Nursing)

Mother Teresa offers light in darkest days
Chan Lai-hung

After a near-death experience, I can truly empathise with my patients. I also have a much deeper understanding of the importance and meaning of my work.

It is often said that the best healthcare workers are those who have the ability to put themselves in their patients’ shoes. In this respect, Chan Lai-hung – who works at Queen Elizabeth Hospital (QEH) – has more understanding than most. Suffering a serious illness in 1993, she experienced some of the darkest days of her life. But she also learnt a lot about never giving up. During her recovery, she read a lot of biographies, including that of Mother Teresa, through which she came to realise that even if she could only accomplish small things, as long as she was doing her best she could have a positive influence on others.

“Many years ago, I underwent a surgical procedure that left me with serious intestinal obstruction. I needed a lot of medical follow-up and suffered further complications, the most serious of which occurred in 1998 when I was pregnant. At only 28 weeks, the perforation of small intestine led to the premature birth of my son, who weighed in at only 1.4kg. I developed pleural effusion and peritonitis and was transferred to the intensive care unit immediately after giving birth. The situation was so serious that my relatives came back to Hong Kong from overseas – I thought my life was coming to an end,” explains Lai-hung.

“Thankfully, I pulled through the worst and slowly began to recover. Yet I couldn’t help but question why I had to undergo such an ordeal. I began reading biographies to try to understand how to better tackle life’s challenges,” she continues.

“I often share my experience with patients – it helps them to know that I understand their pain, fears and insecurities. My ability to truly empathise seems to greatly encourage them.”

Lai-hung would like to thank her family and her nominator for their understanding and support. “My family never complains when I need to work overtime or have to return to the clinic during the holidays to help out with an emergency. I also wish to thank my supervisor, Eva, who nominated me and always offers me encouragement and advice.”

Lai-hung read a lot of books during her recovery and remembers the encouraging words of many well-known individuals, including those of Winston Churchill who said: “A pessimist sees the difficulty in every opportunity; an optimist sees the opportunity in every difficulty.”	After some dark days, Lai-hung picked herself up and now has a renewed sense of optimism about life.

Action shows the greatest love of all!
Dr Lau Pui-yau

My approach to being a doctor is always to ask myself ‘if you were the person lying in this hospital bed, how would you want the doctor to treat you?’ This serves as my guide in interacting with patients.

Dr Lau Pui-yau, Consultant (Orthopaedics and Traumatology) at United Christian Hospital (UCH), will retire in June. He admits he was surprised to learn he would be receiving an outstanding staff award. “I was ready to step down quietly – I never thought that my colleagues would nominate me. When I was told I would be receiving the award, it was quite a shock!”

Dr Lau started his internship in 1977, working at Queen Elizabeth Hospital and Princess Margaret Hospital during the early years of his career. In 1989, he moved to the department of Orthopaedics and Traumatology at UCH. Throughout the past 35 years, he has taken up a number of important positions, including president of Hong Kong Orthopaedic Association, president of Hong Kong College of Orthopaedic Surgeons and chairman of HA Clinical Coordinating Committee of Orthopaedics in a bid to promote Orthopaedic training and surgery development between the Mainland and Hong Kong. He has also volunteered to help patients in remote parts of China, and made significant contributions to the commission of the Sichuan – Hong Kong rehabilitation centre in March.

Dr Lau is an outspoken person, he recalls a time when, as department head of orthopaedics, he was dealing with a serious shortage of manpower. “We only had seven doctors to take care of more than 100 patients and this was creating serious challenges to maintaining the best standards of medical care. I wrote to the Director of the Medical and Health Department. Thankfully, the management were willing to address the issue and agreed to allocate three more doctors to us within 18 months.”

Dr Lau’s deep consideration for patient interests extends to his relationships with colleagues. To ensure a smooth handover, he volunteered to step down from the post of department head in October last year, to allow more time for his successor to familiarise with the management and development of the department.

Dr Lau endeavoured to consider the views and priorities of patients in all his decision-making and actions. He is a true role model for showing how to treat patients with sincerity and respect.

Dr Lau says that any achievements arise not only from his own efforts but also thanks to the great support he receives from his colleagues.	Dr Lau (right) puts his full focus and concentration into treating his patients.

Turn dull wall into lush forest and bring smile to young patients Anna Mak Suk-han

Even if you are working in a small hosptial and doing ordinary duties, if you do it with heart, people will appreciate you.

“I’m just working very hard and I hope that you will be proud of me.”These lyrics from a popular Cantonese pop song might well apply to outstanding staff awardee radiographer Anna Mak.

During her time at DKCH, three major achievements stand out among her many contributions. First, to bring joy to the hospital’s young patients, she organised a group of volunteer painters to transform a stark white wall into a colourful tropical rain forest scene. Second, she was a pioneer in the process of digitising X-rays, making it much easier to share, display and follow up on patient records, and in introducing “computer - on - wheel” system of a mobile computer display that allows patients to see their X-rays from the comfort of their hospital beds. And third, her supervisors, colleagues and patients all commend on her highly personable approach – reflected in the fact that not a single radiographer has left the hospital for the past 15 years. Anna has certainly been working hard to make people proud of her!

“I must offer my sincere thanks to my supervisor. Her trust inspired me to believe I could successfully implement these initiatives. I know some people may think that if you work in a small hospital, nobody will appreciate you. I’m glad to be able to show that if you just keep working from the heart – no matter where you are or what you do – people will see and appreciate it. This award is a great encouragement to me and all colleagues who work in smaller scale hospitals.”

Anna’s hard work at DKCH over 20 years has resulted in a number of significant achievements.	Anna pioneered the process of digitising the hospital’s X-rays about 10 years ago.

Building patient trust key to a satisfying career
Kenneth Shum Lai-him

My uniform was like a superhero costume – as soon as I put it on, I became totally fearless of blood or sputum!

Kenneth Shum has been an Artisan (Physiotherapy) for 33 years. “Not many people understood what physiotherapy was when I joined the industry. I remember being asked during the job interview whether I was bothered by getting dirty. My uniform was like a superhero costume – as soon as I put sit on, I became totally fearless of blood or sputum!

“Back then I lived in Western District but worked at Pok Oi Hospital in Yuen Long. Public transport was terrible at that time and it was a very long journey to work and back every day.”

Kenneth, who now works at Tuen Mun Hospital, says he is lucky to have had good supervisors and colleagues throughout his career. The physiotherapists taught him about the causes and symptoms of different physical complaints, enabling him to better understand his patients. Recently qualified physiotherapists will now ask him to share his opinions and practical experience. He adds he is glad that his skills and knowledge are recognised by his colleagues, but that his greatest satisfaction comes from the trust he establishes with patients.

Kenneth uses his strong communication skills to help people who have concerns or fears about physiotherapy treatment. He says that the key is to relate it to their hobbies and interests and to speak to them as a friend.

“One elderly patient was brought in after losing consciousness. When she came round, I noticed that she spoke with a Shanghai dialect, so I hummed some classical Mandarin songs and asked if she knew how to sing. She really sang them out! When she was taken for some physiotherapy, she refused to even stand up. So I asked her to dance with me and she immediately became animated. It turned out she loved singing and dancing when she was young.” Kenneth ends by saying helping patients such as that old lady and seeing people get better day by day is his biggest driving force.

Kenneth loves playing football. With his distinctive style - includeing his long hair - and active personality, he says an office job wouldn't suit him.

Serving from the heart
Kitty Siu Kam-sau

I strive to serve patients from the heart and will always try to go the extra mile for them.

Kitty Siu began her career as a nurse, but the chance to transfer to the Patient Services Department in 2003 led to an unexpected change in direction. This new path was challenging from the start – on her first day, an angry patient tried to destroy a meeting room with his crutches! Such an extreme experience would scare many people, but Kitty’s desire to enhance the quality of hospital services and build strong relationships between patients and medical staff gives her the determination and dedication necessary to show compassion and understanding for people with frustrations and complaints.

Dr Law Chun-bon, who nominated Kitty for the award, says her success lies in her big heart. Kitty explains: “I strive to serve patients from the heart and will always try to go the extra mile for them.” In just one example of her devotion, when she heard that a patient had passed away on the first day of the Chinese New Year, she immediately went to the hospital to help support and comfort the bereaved.

“I remember another case in which a couple complained that their intellectually disabled son had died while in our hospital. They didn’t shout or cry, but they refused to accept any comfort and their voices were gloomy and full of hate. I explained that all our doctors have kind hearts and certainly don’t want to see any of their patients pass away. The consulting doctor also had a sincere conversation with them. In understanding how much we care, the mother began crying like a broken dam and both parents were finally able to start releasing themselves from the pain of losing their son.”

Kitty says that she only became a nurse because of something her aunt said. “She told me ‘being a nurse is good. You won’t lose your job – even if war breaks out!’” However, after starting her training she quickly found nursing to be a deeply fulfilling career that has taught her many things about life, including the importance of being tolerant and open-minded.

Kitty wishes to thank PMH Chief Executive Dr Nancy Tung Sau-ying, Dr Law Chun-bon, Dr NS Mok, her colleagues, General Manager (Nursing) Philip Choi and former General Manger (Nursing) Lai Sue-fan, as well as her husband who always gives her his full support.

“Sometimes, it can be challenging to carry on when I’m really exhausted. Fortunately, my supervisors and colleagues are always there to encourage and support me.”	Kitty (second from left) always tries to give her best – whether at work in the service of patients or at home as a wife and mother. Every year, her whole family will take a vacation together.

Using artistic talent to help others
Oliver So Wai-sang

I believe everyone has a unique set of strengths and talents. I hope people will use these gifts to overcome their own challenges and to help others.

Since joining Kwai Chung Hospital (KCH) in 1992, Oliver So, Registered Nurse (Psychiatry), has devoted himself to serving people who are dealing with mental illness and to improving community awareness as regards mental health. His many efforts include founding the KCH Drama Group, which won the Hospital Authority’s Outstanding Team Award in 2007. A year later, this initiative was extended to the creation of a branch theatre group for teenagers and teachers, with the aim of using the arts to encourage greater discussion of mental health issues. The Drama Group is also exploring other channels for spreading anti-discrimination and positive mental health messages – including collaborating with the drug addiction treatment section at KCH to produce a music video.

With drug abuse becoming an increasingly serious problem in recent years, Oliver asked to be transferred to the Substance Abuse Assessment Clinic in 2012 in order to help more individuals overcome the mental and physiological challenges of addiction. His deep compassion is evident in his interactions with patients and their families, and he often surprises them with unexpected gifts or acts of kindness, such as buying them a cake on their birthday.

Despite having won team recognition and, now, an outstanding staff award, Oliver is modest about his achievements, noting only that he hopes they will serve to further promote anti-discrimination and greater understanding as concerns mental health. “I believe everyone has a unique set of strengths and talents. I hope people will use these gifts to overcome their own challenges and to help others,” he adds.

Oliver also offers his sincere thanks to Mr Pang Shu-wing who nominated him for the award, and Dr William Lo Tak-lam, Chief Executive of KCH, as well as his colleagues, his patients and their families, and his mother, who always provides him with support when he encounters serious challenges.

Members of the Kwai Chung Hospital Drama Group include Hospital Authority colleagues, family members of patients and volunteers from the community.	Oliver’s (centre) first onstage experience was performing his award-winning script about a person with mental illness. He hopes more people will use strengths to help others.

Unsung heroes turn raw data into useful information
The Clinical Data Analysis and Reporting System (CDARS) Team Hospital Authority Head Office

Patients usually thank frontline healthcare workers for their efforts; yet they may not realise that a team of unsung heroes work very hard behind the scenes to turn a huge mass of raw data into useful information that will ultimately help their frontline colleagues to enhance the quality of services. This year, the endeavours of our colleagues in HAHO Information Technology Services are being acknowledged with an outstanding team award.

The team leader, Dr Lee Yuen-lun, said the data collected from various clinical systems for patient care every day – such as patients’ clinical conditions, A&E consultations, inpatient and outpatient activity records, operating theatre management data, surgical procedures, etc – are transformed and stored in a central database (Clinical Data Repository). Through CDARS data analysis, clinical users and management teams can obtain useful and timely clinical information for supporting healthcare services and clinical management decisions.

“For example, a colleague may ask: How many diabetes mellitus patients had satisfactory HbA1c level in the past 10 years ? What was the waiting time for cataract surgery in one of the HA Hospitals ? What was the most frequently used antibiotic for this superbug and what is its antibiotic resistance pattern ? How many prostate cancer patients were treated with robotic assisted surgery in the past five years?” The CDARS can answer such questions within three minutes. Queries that require complicated data analysis take an average of one hour. All this information helps our colleagues to develop effective strategies to enhance their own specialties, thereby improving the quality and benefits of the services that their patients receive.

Dr Anna Tong , the team’s Senior Health Informatician and Marita Cheng, its System Manager add HA is a knowledge-based organisation, the analysis of the clinical data is particularly important. The CDARS was developed entirely internally, and was piloted in 2002, with the support of frontline colleagues and management. It now has nearly 3,000 active users and received more than 210,000 enquiries last year, an eightfold increase on the first year’s figure. They also point out that the 20-plus training courses about the CDARS that the team organise every year have received an overwhelming response from their colleagues. The team will continue improving the system’s performance and optimising its user interface. They will also explore the feasibility to integrate relevant clinical information to patient care workflow.

Dr Lee says, “The award definitely affirms the achievements of our IT colleagues and proves that – even though they are supporting staff – they still provide the high quality services to the patients!” He also expresses his special thanks to Dr Chong Lap-chun, the award’s proposer; Dr Fung Hong, Cluster Chief Executive of New Territories East Cluster; Nancy Tse, Director (Finance and Information Technology Services) of HAHO; members of the Clinical Management and Reporting Working Group and other teams of ITS colleagues, all of whom have given valuable advice and support to the team over the years.

The team’s leader, Dr Lee Yuen-lun (left),and two of its core members, Marita Cheng (centre) and Dr Anna Tong discuss ways to optimise the ability of the CDARS to meet the needs of frontline healthcare colleagues.	A frontline colleague last year presented the team with this trophy to thank them for developing the system.
Maybe their good humour during the interview – and the funny stuff in their office, such as a LEGO set, Rubik cube and basketball paraphernalia – indicate the secret of how the team have built up their spirit of tacit understanding and creativity.

A quiet revolution in catering services
Health Care Food Service Team Pamela Youde Nethersole Eastern Hospital (Hong Kong East Cluster)

“Wow, this steamed fish is delicious.”
“The quality and temperature of the meals are good.”
“The hospital serves special fish soups to nursing moms helping them to breast-feed.”

Outsiders are always concerned about the catering services for patients. The Health Care Food Service Team of Pamela Youde Nethersole Eastern Hospital (PYNEH) began making revolutionary changes to its food-preparation methods and the quality of its catering services 17 years ago. The innovation started at PYNEH, which had just been opened at the time.

Clara Pi, the team’s leader says change began in 1996 when her team piloted cook chill technology in food production and later implemented cold-plating / end point retherm technology. This technology enables efficient production of safe quality foods in large quantities while maintaining nutrition. This new food production and meal service model became the new direction of the Hospital Authority’s patient food service.

They also worked with their IT colleagues to design, develop and implement the Dietetics Catering Management Computer System (DCMS). DCMS is a comprehensive system encompassing diet-order entry, food purchasing, production scheduling, menu planning and nutrient analysis. DCMS facilitated the standardisation of recipes and integration of regular and therapeutic diets. This system has now been rolled out to all hospital in HA.

Later, the team started to focus on the environmental impact of the nutrition of foods they serve to patients. They implemented a “meat replacement” programme in 2006, where textured soy protein replaced 30% of the meat in meat-cake recipes, and started the “meatless Monday” programme in 2010, in which money saved from buying meat is used to purchase organic vegetables for the patients. In 2011, they implemented the “meat reduction” Balanced Menu programme recommended by the WHO Healthcare Without Harm initiative. This enables the promotion of patient health and our environmental protection.

To reduce food waste, the team has worked with nursing and IT staff and has successfully cut down on meal tray waste from the wards and portions of rice. From 2011 to 2012, PYNEH saved a total of 42,157 kg of food, or an equivalent of HK$431,595.

Currently, the team provides 18,000 meals to 10 hospitals every day, making it the HA’s most effective catering department. Clara says special thanks are due to the great efforts of her colleagues in the kitchen, dietetics department, information technology services department, wards, receptor hospitals and the central food procurement department.

She also feels grateful to the first PYNEH Chief Executive, Dr Pamela Leung, and Mrs Mary Wan, Cluster General Manager (Administrative Services) at HKEC. “They supported me in implementing the new technology that has helped us to improve the quality of our meals, thus leading to today’s achievements.” The team will continue to pursue their mission on health and environmental protection in patient food service through innovation in a bid to assure patient satisfaction.

Cook chill technology makes it possible to produce 2,000 cook-chill meals in two-and-a-half hours for receptor hospitals.
The team adopted the low-carbon concept and implemented a “meat replacement” programme in 2006.	A blast chiller quickly lowers the temperature of steamed and baked menu items safely.

Hong Kong’s first joint-replacement centre
Hong Kong Buddhist Hospital Joint Replacement Centre (Kowloon Central Cluster )

If you needed joint-replacement surgery at Queen Elizabeth Hospital (QEH) a few years ago, you would have to wait for four years and the backlog of cases was 1,000 long. To help patients more speedily, doctors began to seek a suitable site for Hong Kong’s first joint-replacement centre.

Eventually, the Hong Kong Buddhist Hospital (BH) was chosen, and the centre started operating in December 2010. Dr Yuen Wai-hong, one of its team leaders, says the centre focuses mainly on hip and knee-replacement surgery. To date, it has handled more than 1,000 cases, with satisfactory results. In fact, the incidence of wound infections is less than 0.1%, far below the profession’s standard of 1%. The schedule for surgery has increased from one day a week at QEH to four days a week at BH, which has greatly reduced the waiting time for patients.

However, it is not always a good idea to speed things up. That is because most of the patients are elderly, and they are not well prepared psychologically for the surgery. Many of them believed they would need to wait a long time to undergo it, so some of them felt uncomfortable about the shorter waiting time, and they even turned down the opportunity at the last minute. As a result, the operating theatre’s occupancy rate was only 70% to start with. In response, the team immediately came up with a “can’t miss out anyone” replacement mechanism: if one patient doesn’t show up for surgery, they find another one on the waiting list to replace him or her. As a result, the occupancy rate has now increased to 90%.

Dr Eric So, another team leader, adds that the centre has been such designed that its dedicated operating theatre, wards and rehabilitation centre are all on the same floor. That is good, because it allows the team to work together closely and conveniently and provide a “one-stop” service. It also focuses on ways to reduce painful side effects for the patients in future.

The team is very grateful for the support and collaboration of colleagues at QEH and BH, because the latter had no operating theatre, orthopaedic specialists, anaesthesiologists or other related medical staff at the very beginning. The doctors also give special thanks to Dr Hung Chi-tim, Cluster Chief Executive of KCC, and Dr Cheuk Tsan, Hospital Chief Executive of BH. Both of them gave the team valuable advice and support during the process of establishing the centre, which has contributed to the good results it is able to achieve today.

The centre mainly does hip and knee-replacement surgery.	Patients do physiotherapy under the guidance of health care workers.
Dr Yuen Wai-hong (left) and Dr Eric So say the coordination process with the two hospitals was full of challenges; yet they chose to face all of them because of the potential benefits for many elderly patients.	The team plays a game to develop better tactics.
The team plays a game to develop better tactics.

Greater efficiency brightens life for cataract patients
Kowloon East Cluster Cataract Consortium

Back in 2009, there was no concrete plan for the redevelopment of United Christian Hospital. Facing an aging population, together with very limited resources and manpower, the average waiting time for cataract surgery in Kowloon East Cluster was 10 years. A multi-disciplinary team, Kowloon East Cluster Cataract Consortium, was formed. With 10,000 patients on the cataract waiting list, the team was faced with a daunting task. The cluster team brought together the strengths of the United Christian Hospital and Tseung Kwan O Hospital in the cluster. Through streamlining workflow, introducing new technology and providing evidence-based training, the team successfully increased the annual number of cataract surgeries five-fold. Within a period of four years, the average waiting time for cataract surgery in the cluster has dropped from 10 years to just one year.

The outcomes of the initiative have been most promising. Not only has the consortium significantly reduced the number of patients waiting for cataract surgery, it has also improved the lives of many elderly people by reducing their chance of injury due to poor eyesight.

How did the consortium manage to achieve such efficiency while maintaining high standards of service quality and safety? Team leader Dr Kenneth Li, Chief of Service and Consultant Ophthalmologist, explains: “We simplified the cataract preoperative procedure and stratified patients according to their conditions. We redesigned the layout of operation theatres and re-engineered the surgical instruments to achieve safety and efficiency at the same time. Patient safety is our priority and we put a lot of emphasis on surgical safety. The complication rate of our cataract operations is lower than the international average.”

Since its establishment in 2009, the consortium has brightened up the eyes – and the lives – of over 15,000 patients. With a patient satisfaction rate of 99.5%, their efforts are clearly appreciated.

	The Kowloon East Cluster Cataract Consortium performs around 5,000 cases of cataract surgery every year. The team’s dedication to patient care greatly improves the quality of life of cataract patients in Kowloon East.
The close cooperation of the inter-departmental team has allowed more patients to board the ‘brightness express train’ to improved eyesight.

Building a firm foundation for medication safety
NTEC Medication Safety Enhancement Team (Nursing)

A perfect record of clinical safety – the shared desire of patients and their medical carers – is a worthy challenging ambition. But it is exactly this goal that has helped drive the impressive efforts of the New Territories East Cluster (NTEC) Medication Safety Enhancement Team (Nursing).

Jane Liu, the former team leader who is now Chief Manager (Nursing), says they started with comparatively small-scale work. To tackle the issue of the wrong medication being dispensed to patients, the team had established a ‘three checks and five approvals’ guideline. But despite all the nurses understanding the guideline, mistakes still happened.

The team decided to speak with frontline nursing staff to try to uncover where the procedure was falling down. Jane says: “One nurse told me, ‘Dispensing medicines is like knitting – to knit or to purl is easy, but not when we are trying to do it in the middle of Nathan Road.’” It quickly became clear that the nurses were being constantly interrupted or distracted when they dispense the various medications.

“To allow colleagues to concentrate on dispensing medication, we put a ‘Do not disturb’ notice on medicine trolleys, and designed a special jacket for colleagues who are dispensing medicines to wear so that everyone in the ward knows that they should not be interrupted,” explains Jane. But even this wasn’t plain sailing. “Some hospitals found these initiatives very useful, but others said the colour of the jacket was too bright! It would call the patients’ attention to the dispensing nurse, who would then be inundated with questions and requests.”

Another surprise discovery was that there were varying interpretations of what appeared to be straightforward dosage instructions – such as whether the medication should be taken once, twice or four times per day. This had resulted in an uncoordinated medicine-dispensing schedule, which was adding to the risk of mistakes. Jane’s team therefore proposed that medicine-dispensing times be standardised across the NTEC. She notes that this wasn’t an easy task, but with detailed planning after a series of meetings, a unified schedule was successfully implemented.

Dispensing medicine correctly is an essential element in achieving a perfect clinical safety record and remains an important part of the team’s ongoing work. “The team regularly reviews the measures that are now in place and will continue to improve them to enhance medical safety,” says Jane.

She wishes to thank all the colleagues who have contributed to the team’s efforts and is considering how to ensure that all NTEC nurses benefit from the outstanding team prize.

	A special jacket was designed for nurses who are dispensing medication.
‘Do not disturb’signs have been placed on medicine trolleys to alert patients and other members of staff that the dispensing nurse should not be interrupted.

Outstanding Staff and Teams Award 2013