Page 230 - HA Convention 2016 [Full Version]

HOSPITAL AUTHORITY CONVENTION 2016 Service Enhancement Presentations

F8.2 Young HA Investigators Presentations 14:30 Room 421

A Web-based Intensive Care Unit Consultation System with Structured Reply Generation
Ho JKY 1, 2, Chan KC 1, Law CH 3, Cheung CW 3, Tang KS 1, 2, Lam KK 1
1Department of Anesthesia and Intensive Care, 2Quality and Safety Division, 3Information Technology Section, New Territories

West Cluster, Hospital Authority, Hong Kong

Introduction

Poor clinical handover of critically ill patients usually associates with misunderstanding, delay in treatment and adverse
outcomes. Feedback from clinical departments relating to the quality of Intensive Care Unit (ICU) consultation reply include
illegible handwriting, ambiguous ICU admission decision and lack of an appealing mechanism for general team to liaise with
ICU seniors on admission decision.

Objective

(1) To improve the quality of ICU consultation reply and enhance communication among ICU and general ward staff; and (2) to
collect a data pool for audit cycles under a structured and standardised methodology.

Methodology

By collaborating with the New Territories West Cluster (NTWC) Information Technology (IT) Section, the ICU consultation
system (ICON) is designed with linkage to the webpage of the Department of Anaesthesia and Intensive Care in NTWC.
Immediately after urgent patient assessment and resuscitation, ICU doctors can:

• Access the Hospital Authority (HA) computer that supported by clinical system in wards

• Click “ICU consultation database”

• Logon by user name and password

• Submit patient’s hospital number with barcode system

• Classify patient according to Society of Critical Care Medicine (SCCM) Priority System

• Submit patient’s quality of life, physiology and diagnoses for the calculation of the Mortality Prediction Model (MPM0-III)

• Record the history and physical examination.

A structured ICU consultation reply form, involves precise consultation date and time, name and code of attending doctor,
patient’s assessment, definite ICU admission decision and the rationale(s) behind, as well as the appeal mechanism, is
printed. The parent team doctors and nurses can follow up in accordance with the recommendation(s) and contact suitable
person(s) where appropriate. Periodic introduction to rotating staff on the concept and definitions of terms used in ICONS is
conducted on a regular basis to ensure the system compliance and data accuracy during the collection process.

Wednesday, 4 May Result

The system was considered user-friendly. The rate of using printed ICU consultation reply in NTWC increased from 16% to
over 90%. Apart from producing consultation replies, the platform also played a prominent role as a handover tool during ICU
handover round whereas consultation information could be accessible anytime and anywhere within the hospital. Last but not
least, ICON served as a valuable data source for audit cycles, which could help improve ICU service and resources planning.

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