Kudos to the OUTSTANDING STAFF AND TEAMS 2014

Six colleagues and seven teams won recognition at the ‘Outstanding Staff and Teams Award’ this year – let’s learn more about their contributions and experiences as we offer them many congratulations on their achievements.

OUTSTANDING STAFF

Kate Choi Ki-yan	Harris Lam Kai-cheong
Dr June Lau Sze-man	Samuel Law Tat-hong
So Gar-wo	Rebecca Wong Yee-man

OUTSTANDING TEAMS

KWC (PMH) Non-emergency Ambulance Transfer Services Team	Lady Pao Children's Cancer Centre (CCC)
Occupational Safety & Health Team,Kowloon East Cluster	Organ Transplant Coordinators
Princess Margaret Hospital Department of Pathology Specimen Assurance for Excellence (SAFE) Project Team	Vascular Anomalies Multidisciplinary Team
Ventilator-Assisted Children’s Voyage Allies and Companions

‘Knot’ just the usual prize for this year’s Award winners

This year’s Outstanding Staff and Teams Award include a special prize initiative. Each of the awardees will receive the new-look Hospital Authority souvenir tie or scarf, which have been designed by renowned Hong Kong fashion designer William Tang.

William used the HA Bear – which embodies HA’s vision, mission and values – as his central motif. He says: “The bear is a collective memory of two generations. My design reflects a sense of people coming closer together to foster better communications and empathy among healthcare workers and with patients.” William volunteered to create this new design to pay tribute to medical staff. Coupled with a unique pattern and bold composition, the overall look of the new neckwear is both cheerful and energetic.

“The red version goes well with dark colours such as black and blue, while the beige option is a perfect match for lighter-coloured clothing,” William explains.

Quality clinical audit to bring benefit for all

Kate Choi Ki-yan

“If our decision can be of benefit to colleagues, patients or hospital, it is imperative that we persevere and ensure that it comes into effect as soon as possible.”

Kate Choi’s beliefs are built on the firm foundation of a healthcare career which by 16 September 2014 will reach its 40^th year. Currently Senior Manager (Quality and Safety) of Hong Kong West Cluster cum Clinical Audit Manager of Queen Mary Hospital (QMH), Kate began her career as a nurse, gaining 20 years of clinical experience in the Medicine, Obstetrics and Gynaecology, Paediatrics and Adolescent Medicine and Clinical Oncology departments at Queen Elizabeth Hospital and Princess Margaret Hospital respectively before assuming an administrative role at the now-closed Nam Long Hospital.

In 2003, she took up a clinical audit position at QMH where she was responsible for delivery of correct and appropriate care to patients by conducting audits to ensure staff of various clinical departments comply with established clinical guidelines and protocols. Currently, her focus of work is on quality and safety, such as those related to hospital accreditation, ensuring that the hospital is providing high standards of service.

Kate understands that it is never easy to gain everyone’s support for any new policy. She has found that the most effective strategy to convince the hospital management and colleagues is to arm herself with solid evidence of the practical benefits of any new policy.

Her most memorable experience in overcoming resistance was during the QMH accreditation process in 2009 when she was trying to implement a “Nursing Care Plan” initiative that required nurses to fill in a simple form after conducting an initial patient assessment to document the patient's clinical condition in the morning, evening and at night. Designed to keep track of patients' conditions, this initiative was initially met with considerable opposition.

“Two colleagues confronted me angrily, complaining that it was a meaningless procedure,” Kate recalled. “I decided to adopt a ‘softly, softly’ approach and just asked them to complete the form when time allowed. Slowly, they began to see the advantages of the improved record-keeping and how it could support them in their work. It’s now just a routine part of their nursing job.”

Kate loves her work and will never retreat in the face of adversities and challenges. She vows to try her utmost in her future endeavours to benefit her colleagues and patients.

Kate’s husband describes her attitude to work as responsible, committed, diligent and helpful.	Two lovely grandsons are her ‘darlings’ and give her motivation.
Kate is sharing her clinical audits experience with colleagues.

Devotion to service extends from AED to the broader community

Harris Lam Kai-cheong

“When you give your all in pursuit of an objective - big or small- the ultimate result can be unexpected and surprising.”

Harris Lam’s interest in medicine and caring for others started at an early age. As a junior high student, he was a member of his school’s health and medical team and also served in the Civil Aid Service Cadet Corps. Despite opposition from his father, these experiences drove Harris to apply to train as a nurse. After graduating from the school of nursing in 1985, he spent two years as a Surgical Nurse in the Department of Surgery at Tung Wah Hospital before turning his attention to providing first-aid training at a non-profit organisation and, later, continuing his studies in Australia with a Graduate Diploma in Clinical Nursing (Accident & Emergency) and Master in Health Administration. In 1994, he joined Yan Chai Hospital (YCH) as a Registered Nurse in the Accident & Emergency Department (AED) and is now Department Operations Manager of the AED and Specialist Outpatient Departments at Ruttonjee and Tang Shiu Kin Hospitals.

Dedicated to saving lives, Harris draws his resolve from a highly emotional experience he had at YCH. A patient had passed away and Harris was given the difficult task of informing the family. “The man’s wife was pregnant and she just stood there with one hand clasping their six-year-old daughter and the other on her aged mother-in-law. It was a heartbreaking scene,” he recalls. “The memory of that day spurs me on to always give my very best in trying to save lives.”

Harris was a member of the ‘Hospital Authority Emergency Response Team’ that was immediately dispatched to Egypt last year following a hot-air balloon disaster in which nine Hong Kong people died. He assisted the families of the deceased with victim identification procedures, provided counselling and offered compassionate support to relatives facing the most challenging of times.

Harris’ passion for helping people extends beyond his job. He is also an active participant in voluntary work, including as an auxiliary air medical nursing officer of the Government Flying Service, a member of the Civil Aid Services and a medical consultant for the Hong Kong Life Saving Society. He is also periodically invited by universities in Hong Kong and Macau to give lectures and provide advice on training programmes.

“I encourage everyone to use their professional skills and knowledge to contribute to society in their free time. Every small contribution today can make a big difference tomorrow. The positive results of our efforts can grow beyond our expectations to bring significant improvements to health and well-being in Hong Kong.”

Amid his hectic management schedule, Harris will sometimes work in the A&E department.

Harris’efforts to help as many people as possible include active participation in voluntary work.

Haematologist specialist brings warmth to hearts and minds

Dr June Lau Sze-man

“Always try your best, acknowledge your responsibilities and live life without regrets.”

Dr June Lau, Associate Consultant in the Department of Medicine at Queen Elizabeth Hospital (QEH), certainly ‘walks the talk’ when it comes to delivering people-centred healthcare services to haematology and cancer patients.

Among her many contributions, she established herself in 2011 as a pioneer and strong advocate by working in collaboration with QEH’s Accident & Emergency Department (AED) to ensure that leukemia patients with high infection risk receive timely antibiotics injections when admitted to the AED – thereby lowering the risk of medical complications and potentially cutting the required duration of their hospital stay. Later that same year, she put forward a proposal to reduce cross-infections but increase treatment efficiency and enhance staff training by providing a dedicated facility for haematology patients – an action that was instrumental in QEH in establishing a separate Haematology Day Ward in April 2012. Dr Lau also endeavours to promote the development of multidisciplinary treatment in medical oncology, which also include doing research and providing education to cancer patients with HIV.

“Helping patients handle the emotional aspects of dealing with serious diseases such as leukemia is an underappreciated aspect of our job,” Dr Lau says. “I tell them they won’t be facing the future alone as I will always be by their side.”

To manage her own emotional stress, Dr Lau turns to gardening to relax. “If you tend a plant with their seasonal growing pattern, it will strive to flourish in even the most unfavourable environmental conditions," she says. "I aim to provide the proper treatment at the right time and to encourage patients to be positive in facing their challenges. There will always be those who sadly come to the end of life’s journey, but my hope is they reach there without regrets."

Dr Lau began her career as a houseman at QEH in 1993. She was promoted to Associate Consultant in 2005 and, in 2007, was appointed Head of Haematology and Medical Oncology Unit. “Haematology covers diseases such as leukemias, thalassemia, haemophilia, thrombotic disorder, myeloproliferative disease and thrombocytopenia. Haematology treatments have developed rapidly in recent years, but the number of haematology specialists remains low,” Dr Lau explains. “I hope my Award will bring new attention and interest to this important area of medicine.”

Dr Lau hopes more doctors will join as a haematology specialist in the future.

To manage their emotional stress, Dr Lau and her husband Dr Choi Cheung-hei, Consultant of Department of Medicine at QEH, will turn to gardening to relax.

A well-versed terminator of germs

Samuel Law Tat-hong

“I treat my staff like I treat my boss – I respect them and always listen to their opinions.”

Samuel Law, Cluster Operations Manager of the Central Sterile Supplies Department (CSSD) in New Territories West Cluster (NTWC), began as a nursing student at Queen Elizabeth Hospital, working in departments of Medicine, Orthopaedics and Traumatology, Social Hygiene Services and then transferred to Geriatric of Princess Margaret Hospital. In 1991, he moved to Tuen Mun Hospital (TMH) and shifted his focus on the vital job of sterilising surgical instruments and medical equipment to minimise iatrogenic infection risks for patients undergoing surgeries or other invasive treatments.

With over 30 years of frontline and management experience, including time with the Infection Control Unit, Samuel says a 18-month project to renovate TMH’s CSSD stands out. Beginning in 2010, he led a team tasked with enhancing patient safety and sterilisation standards through the implementation of four major improvements:

• extending sterilisation services to operating theatres to ensure all surgical instruments meeting the international standards of sterilisation practice;


• improving the tracking and tracing system for surgical instruments by linking patient data to the relevant equipment to enhance patient safety;


• implementing more stringent environmental monitoring of the CSSD – for example, air particle count, air flow, temperature and relative humidity control standards – and ensuring clear demarcation of dirty and clean areas; and


• strengthening the governance structure through initiatives such as establishing a Cluster Decontamination Safety Committee and closer monitoring of disinfection and sterilisation practices at hospitals in the cluster.

The Australian Council on Healthcare Standards rewarded Samuel and his team’s efforts as “Impressive Achievement” in the Periodic Review in 2012.

His dedication was also highlighted during the 2003 SARS outbreak when, despite having a broken finger, he insisted on working without pause to provide infection control training to 6,000 frontline healthcare workers in just two months.

Samuel emphasises the importance of developing a good team spirit. He tries to remember the names of all his 100-plus staff, holds internal award presentations to boost morale and can often be found supporting his colleagues when they participate in sporting or other competitions.

An accomplished football player, he is also the team manager and coach of the NTWC and HA football teams, with 30 tournaments wins to his credit. His proudest achievement in this regard is five consecutive championship wins for NTWC in the HA Cluster Football Competition – little wonder, then, that his nickname is ‘Tuen Mun Ferguson’!

Samuel (wearing blue) loves football. These days, he mainly focuses on coaching but still likes to demonstrate his skills on the pitch from time to time.

Samuel attaches great importance to building mutual trust relationships with subordinates.

Transporting elderly patients from A to B and back again with love

So Gar-wo

“The safety of all my elderly passengers is of utmost importance in my heart. When they are happy, they get well faster.”

So Gar-wo, a Patient Transfer Assistant with the Geriatric Day Hospital (GDH) at Tuen Mun Hospital (TMH), throughout his 19 years as a driver for TMH’snon-emergency ambulance transfer services.

The GDH patient transfer service team has six drivers who collectively serve about 70 elderly patients and complete around 140 transfers a day. A typical day for Gar-wo will include transferring patients between their homes and the GDH for rehabilitation therapy, compiling the following day’s driving schedule and route, and making pick-up appointments with patients, as well as cleaning the ambulance and checking to ensure that it is carrying its full complement of first-aid items.

Gar-wo’s contributions to enhancing the service over the years include the development of the ‘three checks and five rights' system, which has been widely praised by his supervisors and colleagues. The system uses colour coding to help drivers verify a patient’s transfer record, name tag and hand-carry bag, and thus ensure that the right individual is in the right vehicle at the right time with the right bag and the right medications.

Gar-wo’s happiest and most difficult memories of his time with the Hospital Authority both relate to the comfort and health of his elderly charges. “I was so happy when the GDH moved to its current location in 2007 because patients can reach the hospital lobby directly without the inconvenience of having to use a lift,” he says. “The worst experience for me was during the 2003 SARS outbreak. The GDH was forced to close for a while and this negatively affected the recovery of my elderly clients.”

Now 57, Gar-wo joined HA in his late thirties. “When I was 19, I started my own business. I worked in the watch and jewellery trade for 20 years and was once the manager of staff. Over time, however, jewellery businesses began to relocate to mainland China. But I needed to look after my parents and didn’t want to move, so I became a taxi driver,” he explains. “One day I saw the slogan ‘quality patient-centred care through teamwork’ on an HA banner and it just resonated with me. I successfully applied for a job and began work on 18 October 1995. When I retire in a few years I know I will miss my time with HA and all my colleagues and patients.”

Gar-wo still has a clear memory of the day he joined. “It was a Wednesday and the GDH was celebrating its first anniversary. GDH Manager Miss Queenie Leung (now General Manager (Nursing) at Pok Oi Hospital) welcomed me to the team and invited me to join the cake-cutting ceremony. I was very happy and felt like I was home. That feeling never left me and I’ve treated the elderly patients like members of my family ever since.”

This dedication to the comfort and convenience of his clients and colleagues is part of what makes Gar-wo an outstanding member of staff. He notes that patience and a caring, responsible and disciplined attitude are also important personal characteristics to excel in his type of work.

Gar-wo (right) and his partner always take great care to ensure the comfort and safety of his elderly passengers.

Family is very important to Gar-wo. He has his family's photo saved in his mobile phone.

Developing and implementing diabetes care pathways

Rebecca Wong Yee-man

“When you have a goal, set out to what you need to do with determination and never be afraid of failure.”

Meaningful positive change requires the determination to face a difficult situation and work tirelessly to improve it. Many people choose to avoid such challenges, but Rebecca Wong, a Nurse Consultant (Diabetes) in New Territories East Cluster, isn’t one of them. Her efforts in the field of diabetes care have not only improved patients’ lives but have also contributed to international recognition for the diabetes centre at Prince of Wales Hospital (PWH).

Rebecca joined the Hospital Authority in 1983 as a registered nurse in the Department of Orthopaedics and Traumatology at Queen Mary Hospital. In 1984, she moved to the Surgery and Intensive Care Department at PWH. On the recommendation of Professor Clive Cockram, an endocrinology specialist and local authority on diabetes, Rebecca joined the diabetes care team in the same year and found a new direction for her career.

PWH established the forerunner to the Diabetes Mellitus and Endocrine Centre (DMEC) in 1985. DMEC mainly provides specialised services for diabetics, such as patient education and skills training for self-care, medication and diet control; diabetes complications and patient empowerment; and endocrinological check-ups and support. It also provides training for healthcare workers and public education services.

In 1988, Rebecca was among the first group of nurses to be sent to Australia for training. “Back then, people in Hong Kong knew very little about diabetes. Patients had to visit an Out-patient Department every day to receive their insulin injection,” she explains. “My daily interactions with the doctors and patients at DMEC taught me what to focus on when dealing with diabeties and I began to encourage my colleagues to transfer related cases to us. I even went to the wards and clinics taught patients and their relatives the administration of self insulin injections; diabetes knowledge and self-care.”

Rebecca’s dedication led to an HA ‘Outstanding Award’ for the Centre in 1996. In addition, the International Diabetes Federation named DMEC as one of eight global education centres in 2011.

Explaining the technique for self-care to a diabetes patient.
Teach ward nurses the technique of using insulin pen.

Five-shift a day to safely transfer more patients

Kowloon West Cluster (PMH) Non-emergency Ambulance Transfer Services Team

With responsibility for ensuring safe transfer of mobility-impaired patients to and from Hospital Authority institutions, members of HA’s eight Non-emergency Ambulance Transfer Services (NEATS) Centres provide care for patients by employing their knowledge and skills on the road rather than in the ward.

One of the outstanding teams, the Kowloon West Cluster (Princess Margaret Hospital) NEATS centre (Centre) is home to HA’s largest and busiest NEATS operation. With close to 120 colleagues operating 39 vehicles, the Centre completed around 80,000 transfer requests last year.

In order to continuously enhance the service quality, the team leader Kit Yeung, also the Cluster General Manager (Administrative Services) of KWC / General Manager (Administrative Services) of PMH and North Lantau Hospital explains that the Centre has taken the initiatives to implement six major measures:

• Rescheduling of working shifts: The shift pattern has been rescheduled from two-shift to five-shift a day in order to extend the services from the original 8:00 am to 9:00 pm to 7:30 am to 10:00 pm to better meet the needs of wards and patients without increasing team members’ working hours.


• Shortening of service turnaround time: With the aim of completing most transfers within 30 minutes, measures have been taken to shorten service turnaround time–for example, specialist outpatient services colleagues will take efforts to make appointments for NEATS patients at off-peak hours and arrange ‘express’ line for them when collecting medicine at dispensaries.


• Protecting occupational safety and health: To protect the health and safety of NEATS colleagues, HA Occupational Safety & Health team conducts onsite assessments and trainings to help colleagues avoid work-related injuries when operating in challenging circumstances such as in mountainous rural areas and when carrying patients up and down stairs.


• Tailor-made trainings: Patient Relations Officers are invited to conduct communication trainings for frontline colleagues and the Controllers who are required to communicate with patients frequently. Also, ‘empathy journey’ is designed for NEATS colleagues to conduct role-play exercise and act as transfer patients in order to enhance their understanding and empathy to patients, and to enhance their ‘on-the-move’ skills and to build effective teamwork.


• Caring for colleagues: NEATS supervisors conduct daily briefing to staff before starting work to share with the team relevant traffic and road conditions. These sessions also include a 10-minute pre-work stretching routine.


• Organising a programme of periodic onsite checks, with the aim of providing team members with constructive feedback and support.

“Communication is crucial – not just between NEATS attendants and patients, but also among team members and with managers and supervisors,” says Kit. “When we announced our plan to extend our service operation times, some colleagues were concerned that this would mean longer hours or added pressure. We were careful to explain how the new structure would benefit everyone – patients and staff – by making better use of resources and ensuring ward beds are allocated to those who need them most. We also implemented the change in phases so colleagues would have a chance to see its positive effect. The policy is now fully implemented and enjoys strong support from the entire team.”

Team members warm up for the day with a 10-minute pre-work stretching session.	Onsite checks aims at providing team members with constructive feedback and support.
During scenario-based empathy training, team members take turns to play the role of ‘patient’ for their colleagues, provide guidance on effective patient interaction and transfer techniques.

Fighting childhood cancers with the power of human touch

Lady Pao Children’s Cancer Centre (CCC)
Prince of Wales Hospital (New Territories East Cluster)

The Lady Pao Children’s Cancer Centre (CCC) at Prince of Wales Hospital (PWH) is the largest centre of its kind in Hong Kong. Since commencing operations in 1995, the CCC team has taken a multidisciplinary, ‘human-based’ approach in diagnosing and treating its young patients.

With about 100 new patients each year – many of whom are under five years old – CCC handles about 40% of child cancer cases in Hong Kong. The most common types of cancer seen at the centre are leukemia (40%), brain cancer (25%) and lymphoma (10%), while other cancers such as cancer of bone and liver are also found. Team leader Dr Li Chi-kong, who is also Chief of Service and Consultant of the Department of Paediatrics at PWH, says: “Colleagues from different specialties work together to reach a comprehensive diagnosis and then formulate a tailor-made treatment and follow-up healthcare plan for each young patient. At present, about 80% of the centre’s patients make a full recovery.”

Among the many medical advances made at CCC in 2003, two breakthroughs being particularly noteworthy:

• The introduction of ‘minimal residual disease’ pathologic checking, which uses flow cytometers to accurately measure any remaining cancer cells in the body and provides objective data on the response to chemotherapy. With adjustment of treatment intensity, this helps to reduce the risk of recurrence. The test is now available to all five children cancer units in Hong Kong.


• The introduction of an internal radiation therapy for treating neuroblastomas, which involves injecting a radioactive drug into the body where it will target the cancer cells but sparing the normal cells. CCC is one of the few centres in the world providing this treatment.

Dr Li emphasises CCC’s family-centred approach, under which the member of the team remain in close contact with patients’ families and work hard to build trust that will support a smooth treatment process.

CCC has also set up the ‘Little Life Warrior Society’ in partnership with the Department of Paediatrics at The Chinese University of Hong Kong. The ‘Home of the Little Life Warriors’ at CCC offers patients and their families a comfortable and relaxed environment for enjoying some precious leisure time together to read books, play with toys or use the internet while coming back for follow up.

CCC will eventually move to the Hong Kong Children’s Hospital that is currently under construction at Kai Tak Development Area. Until then, it will continue to operate from its current location in its tireless efforts to combat childhood cancers.

The centre is working to promote excellence in treating childhood cancers through initiatives such as experience-sharing sessions with mainland China healthcare professionals.	Patient discharges are among the happiest moment for the team.
Play specialists from Children’s Cancer Foundation use toys and games to help young patients adapt to their hospital stay by teaching them more about their condition and the treatment they will receive.	A doctor collects a cerebrospinal fluid sample from a young patient to assess whether the cancer cells has spread to his brain.
Yu Chui-yee (left), a three-time Paralympic wheelchair fencing champion, went to the centre for a regular check-up and offered her congratulations to team leader Dr Li Chi-kong for the centre’s work.

Five simple words to promote occupational safety and health

Occupational Safety & Health Team,
Kowloon East Cluster

In 2008/09, Kowloon East Cluster (KEC) had the highest annual rate of injury-on-duty (IOD) among all clusters in the Hospital Authority, with 8.64 IOD cases per 100 members of staff. By last year, however, KEC has moved from bottom of the pile to top of the heap, with an IOD rate of 4.37 cases per 100.

In just five years, KEC has seen a dramatic drop in a wide range of IODs, including manual handling operations (MHO) injuries; percutaneous injuries; and Slip, Struck and Fall, which have been reduced by 66%, 56% and 47% respectively. There has even been a significant decline in IODs caused by workplace violence, which is down by 41%. So just how was this drastic turnaround achieved?

Occupational Safety & Health (OSH) Team Leader, Beatrix Sin, who is also Cluster General Manager (Human Resources) at KEC, explains that the strategy for change was driven by five key ideas. “First, we let colleagues BE AWARE of the main causes of injuries and corresponding statistics through different communication channels. We helped them UNDERSTAND IOD could be reduced or even prevented by training and appropriate risk assessment. Supervisors and frontline staff are HAPPY to make changes through the Team’s support in purchasing appropriate devices and tools, conducting on-site training, etc. Prior to IMPLEMENTING improvement, the Team works with the frontline and supervisors to develop checklists, especially for relatively high-risk tasks, so as to facilitate frontline colleagues to follow. At the same time, supervisors can check if frontline colleagues have worked according to the checklists. This approach makes every colleague get accustomed to ensuring workplace safety as a HABIT.” She believes that the joint effort by management, department heads, supervisors and frontline colleagues is the main reason of the significant decrease in IOD rate. Particularly, she gives special thanks to Cluster Chief Executive, Dr Joseph Lui, for his strong support to improve colleagues’ OSH.

The team believes that every staff is responsible for OSH and therefore it encourages departments and staff at all ranks to be engaged with the issues. For instance, between 2010 and 2012, the team provided strategic MHO OSH training to around 3,600 nurses and supporting staff in KEC. Under the guidance of supervisors, these trained staff were then required to put what they had learned into practice at their workplaces. In addition to providing training, the OSH team also helps departments to establish safety management system and designated OSH structure so as to develop OSH strategies and conduct appropriate training. A team of more than 50 ‘link persons’ was also establishedin United Christian Hospital to ensure OSH information can be efficiently conveyed to frontline staff.

The Team has received external recognition in achieving excellence in OSH. One of the submitted projects titled “The Staff Competency Programme in Manual Handling Operations Management” was awarded the winning prize in Asia Hospital Management Award notably as “Winner” under Human Resources Development Project in 2012. Since 2009, 11 colleagues have been honoured various awards as ‘Hong Kong Outstanding OSH Employees’ by the Occupational Safety and Health Council and Labour Department, and the team members have won the Gold Awards for the past four consecutive years.

Special instruments are used to test the potential risk of certain tasks.
OSH-related manual handling operations training.	The OSH team teaches non-emergency ambulance transfer services staff to perform a simple stretching routine before starting work to help avoid sprains and strains.
Various posters remind colleagues to avoid OSH accidents by adopting safe work practices.	The KEC OSH team has received local and overseas recognition for its efforts to promote a safe working environment.

Team encourages enduring love by encouraging organ donation

Organ Transplant Coordinators
Hospital Authority Head Office

The Hospital Authority’s Organ Transplant Coordinators (OTCs) have a challenging yet vital role to play in helping to save lives. Sadly, their work often begins with a conversation with the distressed relatives of an end-stage or recently deceased patient. Members of the OTC team provide compassion, comfort and care while also explaining how the sad closing of a loved one’s life can offer a chance for others in need.

The seven-member OTC team works on a rotating shift basis to provide a 24-hour service. In particularly challenging or urgent cases, team members will come together to discuss possible strategies for what may be a last chance to save or to extend the life of an organ failure patient. Through good communication and cooperation, the members of the team have built close ties and a highly effective working style that has earned them an Outstanding Award .

The team agrees that the cases in which a seemingly hopeless situation has a happy ending is what keeps them motivated. They note one example in which a man had died from an acute stroke and his family had declined to donate his organs. During a chat with the man’s young son, one of the team members asked him whether he had heard of organ donation and if he thought his father would have wanted to help others in this way. The boy had learnt about organ donation at school and thought his kind-hearted father would like to share his love in this final way. On hearing her son’s words, the man’s wife was moved to discuss the issue again with other members of the family. In just two hours, a “no” became a “yes”, with the family giving their permission for all useable organs (kidneys, heart, lungs, liver, cornea, bone and skin) to be donated in a meaningful gesture of care for others.

Even in cases where a decision not to donate is made, the team still gives their best to help grieving families get through difficult times. Tsoi Chung-lam from Pamela Youde Nethersole Eastern Hospital tells the touching story of a pregnant woman whose husband was in a fatal coma after suffering a stroke. The woman told Chung-lam she felt completely hopeless and wanted to end her life. Chung-lam discussed the situation with team member Jenny Koo from Queen Mary Hospital who was on the following shift and they came up with a strategy. The next day, Jenny arranged a bed to be placed next to that of the husband so that the woman could lie next to him. With the help of some medical equipment, Jenny let the comatose father listen to his baby’s heartbeat while encouraging the woman to keep going in order to raise their child. While there was no organ donation in this case, the team’s actions were valuable in helping to protect the lives of mother and child.

Team convener and Advanced Practice Nurse Cheung Suk-man says: “We are very excited about receiving the Award. We hope it will lead to more people understanding our job and its great value in saving and extending lives.”

Every time, when families of donors and receivers have gatherings, the air is filled with love and happiness of sharing.
The team undertakes various initiatives to promote the importance of organ donation.
The team runs a 24-hour service with members working shifts on a relay basis. Good communication among team members is extremely important.	Families of donors and recipients sometimes make cookies and other snacks to express their thanks to frontline colleagues for their unconditional care and compassion.

Innovative self-developed specimen system

Princess Margaret Hospital Department of Pathology Specimen Assurance for Excellence (SAFE) Project Team
Princess Margaret Hospital (Kowloon West Cluster)

Specimen sampling, fixing, paraffin embedding, sectioning, staining – these are just some of the many small-but-crucial steps involved in processing the thousands of surgical specimens collected at Hospital Authority institutions each day. Every specimen is assigned a unique serial number that must be used to verify its identity at each stage of analysis. Any error in this identification process could have potentially serious consequences.

Since 2010, the Specimen Assurance for Excellence Project Team of the Department of Pathology at Princess Margaret Hospital (PMH) has devised an innovative system that has helped improve patient safety by reducing the risk of identification errors. Team leader Dr Lee Kam-cheong, who is also Chief of Service (Pathology) at PMH and Service Director (Pathology) of Kowloon West Cluster, developed and wrote the system programme according to the specific needs of hospitals in Hong Kong.

“Specimens and the resulting histology slides are like the trunk and leaves of a tree – the system I designed serves as the branches,” explains Dr Lee. “It uses 2D barcodes to link up the complex processing procedures for easy tracking and accurate identification.” The system is currently being used to safeguard identification for all surgical and cytology specimens.

When a surgical specimen arrives at the laboratory, it will be assigned a unique 2D barcode, so will all subsequent samples derived from it in the downstream procedures. When laboratory staff are working with any samples during processing, they can efficiently verify the identity of each of them by scanning the barcodes to ensure it matches the parent specimen, rather than depending only on less reliable manual cross-check of the specimen’s serial number.

Dr Lee’s team included several features in the innovative system that makes it more flexible and efficient than similar systems used overseas. For example, if the number of specimen samples taken by pathologist in a patient’s specimen is changed, the system can automatically update and realign all the associated barcodes. Batching to improve efficiency is possible for certain operations. Also, for better resource management, the system records all consumables used in processing the specimens. Besides, the system has tracking functions so it is easy to know when, where, and at which stages of procedure a specimen is involving.

"Teamwork is so important that, without a shared vision and a sense of ownership by members, it is virtually impossible to develop and implement such a complex system within limited time and resource," Dr Lee adds.

In addition to PMH, the system is also in use at Yan Chai Hospital, Tuen Mun Hospital, Pok Oi Hospital, North District Hospital and Pamela Youde Nethersole Eastern Hospital, and will be gradually rolled out to all HA hospitals.

Each surgical specimen that arrives at the laboratory is given a unique 2D barcode label.
Before undertaking any specimen analysis procedure, laboratory staff will scan the barcode on the specimen container and on the slide to ensure the identification information is the same.
(From left) Reusable wooden paraffin blocks of the 1980s and the single-use plastic cassettes with handwritten code of the 1990s have been replaced by accurate and clear 2D barcodes.

Pioneering operating technique reduces surgical risks for vascular anomalies patients

Vascular Anomalies Multidisciplinary Team
Queen Elizabeth Hospital (Kowloon Central Cluster)

Little more than a decade ago, the study and treatment of vascular anomalies was essentially a field without a name even among most medical professionals. This was due largely to a widespread lack of knowledge about this congenital condition and to its relative rarity in afflicting only an estimated one per cent of Hong Kong’s population.

Vascular anomalies can be divided into two types –haemangiomas and vascular malformations. The main symptom, which can manifest at any age, is the appearance of large bluish-red lumps on the face or body. Although there is no immediate danger to life from the condition, it can significantly alter a person’s appearance and this can have a devastating psychological effect.

Vascular Anomalies Multidisciplinary Team Leader and Chief of Service (Department of Surgery) at Queen Elizabeth Hospital (QEH) Dr Donald Tang explains that vascular anomalies will often distort a sufferer’s face or make them ‘goggle-eyed’, causing personal distress and often withdrawal from normal social activity. In addition, if a sufferer accidently scrapes or knocks one of the lumps, it will easily bleed.

In 2009, a surgeon and a radiologist in QEH with interest in the field visited the United States on a knowledge- gathering mission. On their return, they set up the Vascular Anomalies Treatment Centre at QEH, through which various specialists now study the condition and provide one-stop treatment and follow-up monitoring services for patients.

The team has developed a new Hybrid Procedure, which enables surgeons, ophthalmologist, and radiologists to carry out their treatments at the same time. The first stage of the procedure uses a biplane X-ray angiography to identity the abnormal blood vessels. The abnormal vessels are then injected with a ‘biological glue’ that solidifies and enables their immediate surgical removal with minimal blood loss. As of earlier this year, the team had already successfully treated 20 cases.

Dr Tang says that as vascular malformations have no fixed shape, it is difficult for them to accurately and completely remove them using traditional surgical techniques. He notes that in the past the removal of a thyroid arteriovenous malformation could take as long as 24 hours, whereas now they generally only need four to six hours with Hybrid Procedure. The new operation also reduces the risk of the patient experiencing excess blood loss during surgery.

“We hope to help patients regain their confidence,” Dr Tang says. “We will strengthen public education in the future, so that more people will come and seek treatment at an early stage.”

The team has pioneered the use of a biplane X-ray angiography machine in the operating theatre to enable the fast and accurate removal of the abnormal blood vessels.
Radiologist will inject abnormal blood vessels with a ‘biological glue’ that fixes them in place for easier removal.	The fixing of the abnormal blood vessels reduces the surgery time and the risk of excess blood loss during the operation.
Before treatment and after treatment.

Smoothing out the bumps on life’s journey for ventilator-assisted children

Ventilator-Assisted Children’s Voyage Allies and Companions
The Duchess of Kent Children’s Hospital at Sandy Bay (Hong Kong West Cluster)

Travelling down the winding road that leads to the Duchess of Kent Children’s Hospital at Sandy Bay (DKCH) can sometimes be a challenge – reflecting the personal journeys of the hospital’s young charges, including a number of children who are dependent on ventilator to help them breathe. For the past 16 years, a dedicated group of professionals has worked tirelessly to smooth out some of the bumps in life’s road for these young patients, who they lovingly refer to as ‘VACVAC’.

Established in 1997, the early VACVAC team was a modest affair with just a few colleagues. However, the positive effects of the team’s work motivated those involved to redouble their efforts. The team has since grown to include doctors, nurses, physiotherapists, occupational therapists, speech therapists, medical social workers and clinical psychologists who work together to provide trans-disciplinary care, with more than 50 patients assisted to date.

“The team focuses on rehabilitation services, helping ventilator-assisted children whose condition have stabilised to reintegrate to the community and educating their parents about necessary at-home care,” says Dr Lee So-lun, Consultant at DKCH and leader of the VACVAC Team. “We continue to monitor patients which enable us to take action at an early stage if there is any deterioration.” To help boost the spirits of long-term -stay young patients, the team at DKCH often organises birthday parties, performances by ‘clown doctors’ and special visits by volunteers.

Dr Lee appreciates the hard work of the VACVAC team and is delighted to see her colleagues make full use of their skills and ingenuity to provide a better quality of life for chronically ill children. “Recognising the team with an Outstanding Award will greatly encourage them in their continuing efforts,” she says. “It will also highlight the situation and needs of these children, which may attract more community resources to assist them.”She adds that this latter issue is of particular importance due to the fact that ventilator-assisted children usually require long-term care – in some cases, from their day of birth to their end of life. Tangible resources aside, however, the VACVAC team continues to provide powerful medicine in the form of the close, life-long bonds its members establish with so many of their patients.

Specialists from different healthcare disciplines provide training and assistance that is designed to help ventilator-assisted children live full and active lives in the community.	A physiotherapist teaches carers with a manikin how to use a suction catheter to remove sputum from an artificial airway.
The team customised rehabilitation plans for each patient. This walking assistance trolley was tailor-made by an occupational therapist to meet two-year-old Jayden’s specific needs.	The team organises various activities to enhance the children’s quality of life while they are in hospital.

2014 OUTSTANDING STAFF AND TEAMS AWARD