Bringing comfort and closure through after-life care

The mortuary – a place that most people prefer not to think about. Even long-serving hospital staff may have little idea about what goes on in this ‘mysterious’ part of the building.

Wong Sze-keung has worked in the mortuary at Prince of Wales Hospital (PWH) for 18 years. “My role as a mortuary technician involves assisting with autopsies – collecting samples and performing tests to determine cause of death,” he says. Located in a new building with advanced facilities and a simple and bright design, the PWH mortuary is not the gloomy environment that one might expect.

Wong explains, “The standard practice is to take a small sample from all the organs for testing. However, in certain special cases – and given that PWH is also a teaching hospital – we may sometimes collect extra samples, such as bone specimens.”

Wong says the most important part of his job is being able to respond quickly and accurately to the pathologist’s instructions. “Autopsies must be conducted efficiently and with precision. We must take care not to damage the organs when collecting samples, ensure any organs that are removed for sampling are put back in the right place, and carefully sew up the incision,” he explains.

He notes that the work of mortuary technicians has an importance that extends beyond determining cause of death – including contributing to medical research and our understanding of wider public health issues. Citing the example of SARS, he says: “The virus was identified by doctors, but it was people like us who collected the test samples.”

Wong has never considered a different career. His family is also supportive of his choice. “When my daughter was a primary student, she asked me about my job,” he says. “I told her I helped doctors to perform autopsies. This upset her at first, but when she told her classmates, they praised me and told her I must earn a lot of money! They thought I was a doctor – this certainly cheered my daughter up!”

Wong says more families now know that, in most cases, they can prevent an autopsy on their loved ones by signing a few forms and this has led to a drop in the number of autopsies carried out in more recent times.

Wong explains that procedural techniques have also evolved. “We’ve moved from the British-style Y-shape and American-style double-door incision methods to a locally developed ‘Hong Kong-style’ in which a single incision is made in the middle of the body to minimise the size of the opening.”

Wong says he is an optimist with a fatalistic outlook on life and no fear of death. But he acknowledges that his job has its challenges. "When I train new recruits, I often tell them about vomiting during my first autopsy," he says with a laugh. While fewer people are joining his profession these days, there are still those who are interested and a man in his 20s recently joined Wong’s team.

Tools for autopsy work.

The tubes in his hands are for collecting blood samples.

Washing with care

Located next to Pamela Youde Nethersole Eastern Hospital (PYNEH), the Hospital Authority’s Chai Wan Laundry handles 25 tons of laundry – enough to fill a couple of containers – every day.

The facility takes in items from PYNEH, Kwong Wah Hospital, Tseung Kwan O Hospital, Tung Wah Eastern Hospital, Department of Health clinics and HA general out-patient clinics. Around 120 staff work in two shifts to wash the equivalent of 55,000 items of clothing a day to ensure staff and patients always have clean garments and linens.

Cheung Kwai-har has worked in the laundry for over 10 years. She says that clean clothing and linens are not only vital for the comfort and health of medical staff and patients, but also reflect the professionalism of HA and its employees.

Items that may possess an infection risk undergo a special disinfection treatment before they are sent for washing. On arrival at the laundry, the clothing of staff and patients is separated, and then further divided by colour and by washing programme that will be used. All clothing and linens are disinfected using ozone or high temperatures as part of the cleaning process.

The laundry has changed a lot over the years. Cheung notes that many of the changes have improved efficiency. “We used to shake out washed bed sheets one by one by hand. Now we have machines to do this, saving a lot of time and energy.”

Laundry manager Karen Lee says that each set of washing machines at the laundry can wash up to 800 items of clothing an hour. She adds that improvements in the material used to make hospital clothing have also been beneficial. “In the past, the material used for staff uniforms wrinkled very easily. Since changing to a mixed-fibre fabric, uniforms are virtually wrinkle-free after washing and no longer need to be ironed.”

What has been the most difficult thing to wash? Cheung’s view is that the old-style blankets were the most challenging. “The old blankets were heavy and rough. The new blankets are much softer and lighter – and much easier to wash – and they are warmer too,” she says.

Even after 10 years, Cheung still enjoys her laundry work. “I’m very happy to work here. Even though I’m only a small part of the whole washing process, everyone in the laundry has an important part to play in ensuring that our colleagues and patients have clean and safe clothing.”

Hanging for drying	Folding
Piling	Ironing
A new set of work clothes for members of HA’s professional staff.	Clean and sharp nurses’ work clothes are ready.

Always on the move

Beep! “Urgent 82323 transfer patient from H9 to B1 endoscope, bed no. 21, one person”

Beep! “82391 transfer patient from R8 to RTLA. Note: bed no. 25 LA5, one person”

She receives at least 30 calls per day.

At a hospital, patients needing to be safely transferred from one location to another are handled by a hospital porter.

Ko Po-chu is a 3B Operation Assistant in Queen Elizabeth Hospital’s (QEH) Portering Service Unit, which collectively handles over a thousand transfer orders a day.

Like all HA porters, Po-chu always carries a pager with her when she is at work. “Before the system was computerised, porter orders would be made by phone to a central station. After we completed a transfer request we would have to come back to this station to receive our next order,” says Po-chu. “Now that our orders are issued via our pagers we don’t need to return to the office and we can transfer a greater number of patients.” In urgent cases, the porters need to arrive at the pick-up point within five minutes. For ordinary transfers, they are required to complete the order within 15 minutes.

Given the amount of walking Po-chu does in an average day, it’s not surprising that she gets through two pairs of work shoes a year. Her top tip for tired feet is to soak them in hot salt water. “This helps to alleviate aches and inflammation,” she explains.

QEH’s Portering Service Unit currently has 90 members of staff who work in three shifts to serve the entire hospital. “Working here is like being part of a big family. As my job takes me to every part of the hospital, I’ve been able to meet ‘relatives’ working in all the various departments and wards,” Po-chu says.

As QEH is a fairly large hospital it’s especially important for new porters to learn the quickest routes from one place to another to avoid getting lost and walking further than is necessary. “In the first few days, I got completely confused in the basement of Block R,” Po-chu laughs. "This experience made me determined to learn my way around as quickly as possible and, in less than a week, I already knew all the routes - and a few shortcuts!"

Despite its challenges, Po-chu keeps a smile on her face. “I seldom smiled in the past, but my job at HA has taught me the value of a positive attitude – it’s really encouraging to the patients,” she says. And what makes her most happy? “Seeing patients recover and when colleagues express their appreciation for the service provided by the porters.”

This is her running shoe.	For anyone who needs to find their way around QEH, Po-chu is a walking, talking map.
See my muscle.

Delivering the taste of health

Hospital food hasn’t traditionally enjoyed the best of reputations. However, Vivian Chen is on a mission to change negative perceptions of inpatient cuisine. As Hospital Chef I at Princess Margaret Hospital (PMH), she and her team are working to produce meals that are not only healthy, but also delicious and well presented.

Vivian, joined PMH’s Dietetics and Catering Department in 1993. Her passion for high standards of catering has continued to develop since joining the hospital’s kitchen, and it is this that drives her to create appetising meals that also meet a wide range of nutritional and dietary needs.

Referring to the public’s poor image of hospital food, Vivian offers her perspective. “Patient meals must be fresh, healthy and safe, and there are patient dietary requirements to consider,” she explains. “We don’t add a lot of salt, fat and other unhealthy flavour enhancers that are often used at restaurants and dishes can taste different – but that doesn’t mean they can’t taste good.”

Vivian and her colleagues also plan well ahead to provide a diverse menu. “At Princess Margaret, we have an 18-day menu cycle, so even long-stay patients will enjoy plenty of variety,” she says. We are also striving to create more dishes that use seasonal ingredients.”

How does Vivian ensure her meals meet all the requirements? She explains that the Hospital Authority has an extensive electronic recipe database. In addition to detailed information on ingredients, preparation and cooking techniques, each recipe includes comprehensive nutritional data.

PMH provides about three thousand patient meals a day. In addition to medically related nutritional and dietary requirements, Vivian’s team must also cater for individual preferences – such as vegetarian and halal meals – and employ different preparation techniques, including providing minced and pureed dishes.

“When we prepare special meals for individual cases, the computer system will automatically select a suitable meal based on dietary needs and preferences,” she explains. “For example, diabetic patients’ breakfast will automatically be flagged to receive unsweetened oats.”

Measuring spoons for 6oz and 8oz.	By 4:30pm every day, PMH staff are busy serving dinner to all the patients.
This huge vegetable-washing machine helps ensure patients enjoy vegetables that are safe and clean.	Vivian always taste-tests the kitchen’s food before it is served. The freshly cooked chicken with red peppers and white sauce is delicious: “Pass!”