Page 199 - Hospital Authority Convention 2018

Corporate Scholarship Presentations

C3.4 Chronic Disease Management 14:30 Room 428

Rehabilitation Nursing in St. John Rehab in Toronto, Canada
Lo JOY
Department of Geriatrics and Rehabilitation, Haven of Hope Hospital, Hong Kong
The Overseas Corporate Scholarship Programme for Clinical Leaders aims to build up clinical leaders’ new capabilities in HOSPITAL AUTHORITY CONVENTION 2018
health illness and management, and care delivery in Hospital Authority service priorities. On behalf of Rehabilitation Nursing,
four Advanced Practice Nurses (in two separate groups) were delegated to join a four-week international observership at St.
John’s Rehab (SJR) at Sunnybrook Health Sciences Center in Toronto of Canada in May and June 2017 respectively.

With the mission of rebuilding people’s life and advancing rehabilitation science, St. John’s Rehab, a 160-bed non-profit
public facility, offers a continuum of care from in-patient to out-patient individually customised rehabilitation programmes for
different conditions including amputations, burns, cardiovascular surgery, oncology, organ transplants, orthopaedics, stroke
and neurological conditions, traumatic injuries and complex medical conditions.
Besides fruitful observation, learning and discussion, there are lots of impressed elements in SJR which helps us acquire
different knowledge on rehabilitation nursing such as Person-centred Care (PCC), Interprofessional Collaboration (IPC)
and discharge planning. PCC focus on person when providing care to patients, it encourages working collaboratively with
patients and their families to promote their engagement on own health management. IPC is about shared goals – disciplines
speaking together on a common goal to deliver the highest quality of care. It is non-hierarchical decision-making and
promotes relationships among patients, their families and health professionals. For timely discharge to ensure appropriate
use of resources, discharge planning strategies in SJR include the targeted length-of-stay, the estimated discharge date,
revision of EDD through IPC meeting, best practice and tools on standardised discharge, and the Provincial Alterative Level
of Care Policy for escalation of complex discharge cases.
This overseas observership provides an unforgettable exposure on the services of rehabilitation nursing in Toronto that
certainly broadens our horizons. It is a valuable chance to equip ourselves for future challenges. Last but not least, patients in
rehabilitation are often dealing with the biggest life changes that we can imagine. If we can bring a bit of change to their day,
it is a great honor to us, as a rehabilitation nurse.

C3.5 Chronic Disease Management 14:30 Room 428

Renal Nutrition Care Overseas Experience
Leung E 1
1 Department of Dietetics, Queen Mary Hospital, Hong Kong

The Overseas Corporate Scholarship Programme for Dietitians in Renal Nutrition Care is a 10-day training programme at St.
George Hospital in Sydney, Australia. It aims to build up new competencies, enhance knowledge and disease management
skills for dietitian in renal nutrition care.

St. George Hospital uses a strong multidisciplinary approach in renal patient care. They have multidisciplinary outpatient
clinics that is composed of renal and palliative care physicians, nurses, renal dietitians, pharmacists and social workers.
Studies have demonstrated that early referral of patient with chronic kidney disease (CKD) to a multidisciplinary renal Tuesday, 8 May 2018
clinic was associated with reduced rates of kidney failure decline, hospitalisation, morbidity and mortality. Timely nutrition
interventions are vital for a healthy start to dialysis and may prolong pre-dialysis period.

Renal Supportive Care (RSC) is an alternative treatment pathway in advanced CKD. It is based on the principle of palliative
care by focusing on patient-centred care, quality of life and symptom control. Nutrition intervention plays an important role
to maintain patient’s quality of life, physical functioning and to reduce symptom burden. St George Hospital has introduced a
RSC clinic with a multidisciplinary team.
Validated tools such as Subjective Global Assessment and Integrated Palliative Care Outcome Scale were widely used by
renal dietitians in St. George Hospital to measure nutritional status and symptom burden, respectively. The application of
these assessment tools help monitor patient’s progress and outcome. They also provide direction in nutrition intervention and
to identify service gap.
The Attachment Programme for Dietitians in Renal Nutrition Care is a valuable training experience for a better understanding
of the health delivery model for renal patients in another country. A strong multidisciplinary approach that is focused on
monitoring and improvement of patients’ clinical outcomes is highly beneficial to local renal services.

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