Page 120 - Hospital Authority Convention 2017

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2017

F1.2 Better Manage Growing Service Demands 10:45 Room 421

An Effective Bed Management Strategy Alleviating Access Block Problem in Prince of Wales Hospital
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Chan SP , Ho B , Tong M , Chung J , Kwok A , Chui ST , Chan J , Tong A , Chau M , Chang S , Chan A 9
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Central Nursing Division, Accident and Emergency Department, Medicine and Therapeutics Department, Surgical
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Department, Orthopaedics and Traumatology Department, Intergraded Ward, Gynaecology Department, Oncology
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Department, Pediatric Department, Prince of Wales Hospital, Hong Kong
Introduction
Prince of Wales Hospital (PWH) is under increasing pressure to meet with the service demand due to a growing and ageing
population in Shatin district. With limited acute hospital bed capacity, access block has always been an issue, which resulted
in overcrowding in Accident and Emergency Department (AED), treatment delay and patient dissatisfaction. Therefore, there
is an imminent need to reduce access block so as to maintain quality and safe patient care.
To achieve our goal of assuring all patients waiting for admission in AED would be taken care of in a timely manner, Central
Nursing Division (CND) took the lead to work with departments and devised a proactive bed management mechanism that
has been implementing in PWH since 14 November 2016.
Objectives
To set up a proactive mechanism for bed management in PWH that enables timely arrangement of inpatient beds for AED
Tuesday, 16 May Methodology
patients waiting for admission and minimises cases waiting for admission in AED >12 hours.
To achieve our goal in setting up an effective proactive bed management system, several principles were adopted in this
enhancement programme: (1) Assign on-site designated persons to be responsible for bed arrangement; (2) define regular
time slots to screen AED waiting cases; (3) initiate early preparation in bed arrangement; (4) encourage early escalation of
support mechanism if necessary.
To ensure full coverage of the bed management mechanism, we have identified different bed coordinators and screening
time for AED cases in three specific time zones. In addition to the usual arrangement of patient admission between AED and
wards, designated bed coordinators would screen cases in AED in a specific time slot and then proactively plan and arrange
beds for all patients to be admitted within their shift. If any difficulty was predicted, bed coordinators were advised to make
early contact and seek support from senior managers and other departments.
Information on this mechanism and a list of departments’ bed coordinators with their contact phone numbers were denoted
and uploaded to iCND webpage for easy reference.

Results
In 2016, the percentage of access block with waiting time for admission>12 hours was ranged from 0.7% to 13.7% per month
before the commencement of this proactive mechanism. The hospital is very pleased to find that, after this initiative was in
effective in mid-November, the percentage of access block with waiting time for admission>12 hours has been drastically
decreased to 0.02% in December 2016 and further to 0% in January 2017. The proactive bed management mechanism has
been proven effective in enhancing patient flow and reducing access block problem in hospital.

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