Page 135 - Hospital Authority Convention 2017

Service Enhancement Presentations

F3.3 Clinical Safety and Quality Service I 14:30 Room 421

A Pilot Project: Implementation of Duplication Checking for Ultrasound Examinations in Princess Margaret
Hospital
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Chui AKF , Au DYS , Pang JYW , Cheung JKH , Leung BCH , Leung RCK , Chan TY , Cheung NT , Cheung AWM , Yung A , HOSPITAL AUTHORITY CONVENTION 2017
Khoo JLS 3
1 Information Technology and Health Informatics Division, Hospital Authority Head Office, Radiology Division, Kowloon West
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Cluster, Radiology Division, Hong Kong East Cluster, Hospital Authority, Hong Kong
Introduction
Radiology examinations are commonly applied in clinical settings for diagnoses nowadays. In view of the huge demand for
radiology examinations, there is a need for optimal use of resources by reducing duplicated requests. Princess Margaret
Hospital (PMH) was the pilot site to apply the duplication checking feature for ultrasound examinations in the Clinical
Management System (CMS). The pilot project started on 1 February 2016. The efficacy of reducing duplicated requests was
reviewed after nine months.
Objectives
To reduce duplicated requests of ultrasound examinations in PMH.
Methodology
In the Generic Clinical Request System (GCRS) of CMS, a duplication checking feature was designed for radiology requests.
A pilot was done in PMH on all radiology requests raised through GCRS. Duplication prompt would alert clinicians at the
time of request if the same ultrasound examination had been requested within a defined period. Clinicians will be prompted
to reconsider the request if: (1) the same ultrasound examination was requested in PMH GCRS within 30 days; (2) the same Tuesday, 16 May
ultrasound examination in PMH Radiology Information System (RIS) with appointment within 30 days; and (3) the same
ultrasound examination in PMH RIS with registered date within 30 days. Clinicians can opt to proceed with a reason or abort
the request directly. The system would record the actions taken by clinicians upon the duplication prompt, so that the efficacy
of the duplication checking can be reviewed.

Results
After nine months of implementation of the duplication checking feature, statistics was collected and results showed that one
in 10 (1,749 out of 17,550) of the ultrasound requests were duplicated according to the defined criteria. Among the duplicated
requests, around 30% (522 out of 1,749) of the requests were finally cancelled upon the duplication prompt.
Conclusion
The duplication checking feature is effective in reducing the duplicated ultrasound requests in PMH. The results were
reviewed by Coordinating Committee in Radiology, and the Clinical Request and Decision Support Working Group. It was
concluded that the pilot was effective in preventing duplicated ultrasound request, and the feature would be adopted in the
CMS of all Hospital Authority hospitals.

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