Page 146 - HA Convention 2015

Symposiums

S9.3 Strengthening Collaboration – from Inpatient to 09:00 Convention Hall C
Ambulatory Care

Tuesday, 19 May Thinking Out of the Box — Ambulatory Service in Hospital Authority
Ng WL
Department of Medicine and Geriatrics, United Christian Hospital, Hong Kong

At the time of abstract writing, the winter surge storm is still gaining force and yet to reach its full strength. Hospitals are
plagued by overwhelming attendances and admissions. Wards have been stretched beyond their limits and access blocks
are rampant. Such annual surges in hospital bed demand seem highly predictable and yet poorly preventable.

As frontline clinicians, we have front-row seats at the floodgates. While many patients presented with severe illnesses
warranting admission, there exists a sizable proportion whose conditions can be managed by a focused and tailored care
process delivered in an ambulatory setting without need for prolonged hospital stay. Examples include relatively stable
patients requiring complex medical care by specialists and/or diagnostic or therapeutic procedure that cannot be delivered
otherwise in community or as outpatient.

The ambulatory concept is nothing new. Our surgical and anaesthetic colleagues have long transformed many inpatient
surgical procedures to day-surgery setting. In this regard, Internal Medicine appears a laggard despite making no less
progress in knowledge and technological advancement. The diversity in disease manifestations, severity and therapeutic
options is but one hurdle in terms of patient selection and development of care pathway. More importantly, gaps in existing
care model, infrastructures, healthcare financing, as well as professional training and career pathway have critical impact on
the full realisation of the potential and power of ambulatory service.

Ambulatory care should be considered for every patient before inpatient admission. It’s time to expand our healthcare arena
and armamentarium. To do so, the focus is not only to invest in hospital buildings and beds, but also to bring out the best in
the people delivering ambulatory care, namely, specialists and nurses supported by the necessary training, infrastructures,
and conducive policies. Solution to the intractable capacity problem is to be found through collaboration between frontline
professionals at the bedside and leaders in the boardroom.

HOSPITAL AUTHORITY CONVENTION 2015

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