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ContentsOrganis<strong>in</strong>g Committee 3Scientific <strong>Programme</strong> Committee 4Convention Management Committee 4Acknowledgement5Convention Secretariat 5Messages fromChief Executive 6Hong Kong Special Adm<strong>in</strong>istrative RegionThe Secretary for Food and Health, 7The Government of the Hong Kong Special Adm<strong>in</strong>istrative RegionThe Chairman, Hong Kong Hospital Authority 8The Chief Executive, Hong Kong Hospital Authority 91HOSPITAL AUTHORITY CONVENTION 2013Outstand<strong>in</strong>g Staff and Teams Award 2013 10Venue Floor Plans 13Scientific <strong>Programme</strong><strong>Programme</strong> at a Glance 14<strong>Programme</strong> by Day 15<strong>Programme</strong> by First Author 25Service Priorities and <strong>Programme</strong>s 30– Speed Presentations 31– Poster Presentations 39AbstractsWednesday, 15 May 201363Plenary Sessions (P1 – P5) 64Plenary Session I – Susta<strong>in</strong><strong>in</strong>g Quality Healthcare ServicesPlenary Session II – Partner<strong>in</strong>g for HealthcarePlenary Session III – Utilis<strong>in</strong>g Healthcare ResourcesPlenary Session IV – Modernis<strong>in</strong>g HealthcarePlenary Session V – Ensur<strong>in</strong>g Emergency PreparednessParallel Sessions (PS1 – PS5)70Parallel Session I – Emergency: Are We Prepared? How We Do It?Parallel Session II – HA Improvement InitiativesParallel Session III – Engag<strong>in</strong>g Staff for PerformanceParallel Session IV – New Horizons of Nurs<strong>in</strong>g PracticesParallel Session V – New Horizons of Allied Health PracticesSpecial Topics (ST1 – ST2)81Special Topic I – Ch<strong>in</strong>a HealthcareSpecial Topic II – Medical LeadershipService Priorities and <strong>Programme</strong>s Free Papers (SPP1 – SPP4)83Enhanc<strong>in</strong>g Healthcare DeliveryConsolidat<strong>in</strong>g Service ProvidersConsolidat<strong>in</strong>g Service ReceiversQuality and Safety <strong>in</strong> Healthcare I
2HOSPITAL AUTHORITY CONVENTION 2013ContentsAbstractsThursday, 16 May 2013111Symposiums (S1 – S12)112Symposium 1 – Patient SafetySymposium 2 – Partner<strong>in</strong>g with PatientsSymposium 3 – Maximis<strong>in</strong>g EfficiencySymposium 4 – Change: How?Symposium 5 – Modernis<strong>in</strong>g Healthcare: The Need to ChangeSymposium 6 – Credential<strong>in</strong>g and Practice PrivilegesSymposium 7 – Partner<strong>in</strong>g with PrivateSymposium 8 – Optimis<strong>in</strong>g OutcomesSymposium 9 – Creat<strong>in</strong>g ValuesSymposium 10 – Change: Why and to Where?Symposium 11 – Hospital AccreditationSymposium 12 – Partner<strong>in</strong>g with CommunityMasterclasses (MC1 – MC4)129Masterclass I – Recent Surgical DevelopmentsMasterclass II – New Frontiers <strong>in</strong> Medic<strong>in</strong>eMasterclass III – Creat<strong>in</strong>g a Positive Environment: Build<strong>in</strong>g a Magnet HospitalMasterclass IV – Toxicology ServicesSpecial Topics (ST3 – ST4)137Special Topic III – New Models of Healthcare Delivery SystemSpecial Topic IV – Medical SimulationCorporate Scholarship Presentations (CS1 – CS2)139Corporate Scholarship Presentation 1 – Cancer and Pa<strong>in</strong> Management ServicesCorporate Scholarship Presentation 2 – Paediatrics and Rehabilitation ServicesService Priorities and <strong>Programme</strong>s Free Papers (SPP5 – SPP8) 145Quality and Safety <strong>in</strong> Healthcare IISusta<strong>in</strong>able WorkforceModernisation of HealthcareYoung HA Investigators PresentationsFloor Plan for Exhibitions 173Exhibitors 174Sponsors176© 2013 Hospital AuthorityDisclaimerThe op<strong>in</strong>ions expressed are those of the speakers and authors only and do not reflect the views of the conferenceorganiser or the sponsors. They accept no responsibility for the content of the abstracts, the use which may be madeof the <strong>in</strong>formation, nor the op<strong>in</strong>ions and views expressed <strong>in</strong> this publication.
3Organis<strong>in</strong>g CommitteeChairman Mr Anthony WU*Vice-Chairman Dr PY LEUNG #Members Dr Derrick AUMs Margaret CHEUNGDr WL CHEUNGDr FUNG HongDr CT HUNGDr CC LAUDr HW LIUDr Albert LODr SV LODr Joseph LUIDr CC LUKMs Nancy TSEDr Nancy TUNGHOSPITAL AUTHORITY CONVENTION 2013* Chairman of Hospital Authority Board#Member of Hospital Authority Board
4HOSPITAL AUTHORITY CONVENTION 2013Scientific <strong>Programme</strong> CommitteeChairmenMembersDr CT HUNGDr CC LAUDr Derrick AUMs Margaret CHEUNGDr Reg<strong>in</strong>a CHINGDr Alexander CHIUMs Ivis CHUNGDr KL CHUNGProf TF FOK ^ (up to 31 December 2012)Dr FUNG HongMs Sylvia FUNG (up to 31 December 2012)Dr KH LEEDr Libby LEEProf SP LEE #Dr Donald LI ^ (up to 30 November 2012)Dr Theresa LIMs Jane LIU (from 1 January 2013)Dr SH LIUDr Albert LODr Joseph LUIDr CC LUKDr FC PANGMs Nancy TSEDr Nancy TUNGConvention Management CommitteeChairmenMs Margaret CHEUNGDr SV LOMembers Mr YK CHENG #Ms LY CHIANG #Ms Qu<strong>in</strong>ce CHONG #Ms Cecilia CHUDr TY CHUIMs Anna LEEDr Libby LEEMr Desmond NGMs W<strong>in</strong>nie NG #Mr Frankie YIP* Chairman of Hospital Authority Board#Member of Hospital Authority Board^Ex-member of Hospital Authority Board
5AcknowledgementSpecial thanks go to the HA Drummer Team for perform<strong>in</strong>g at the ConventionOpen<strong>in</strong>g, Dr Cyrus TSE and Ms Joana YU for be<strong>in</strong>g Masters of Ceremonies and alsoto Ms Mei S<strong>in</strong> LAM, Ms Irene SHIU and Dr Hon Kuan TONG for serv<strong>in</strong>g as on-sitefirst aiders.Convention SecretariatHOSPITAL AUTHORITY CONVENTION 2013Convention SecretaryDesignLogisticsMedia RelationsPhotography<strong>Programme</strong> LiaisonPublicationsRegistrationSocial <strong>Programme</strong>Mr Banny WONGMr Vasco LEEMr Daniel WONGMs Fiona SUMMs Monita SITMs Monica MOMr Brandon CHEUNGMr Steven YEUNGMr Raymond LOMs Kellen PAKMr Robert LAMMr Kwok Wai WONGMs Hoi L<strong>in</strong>g TSANGMs Lavender CHEUNGMs L<strong>in</strong>da SHUMs Circle LOMiss Sandy CHUMs Cynthia KONGMiss Sandy CHUMr Brandon CHEUNGMs Cynthia KONG
6HOSPITAL AUTHORITY CONVENTION 2013Message fromChief ExecutiveHong Kong Special Adm<strong>in</strong>istrative RegionI am delighted to welcome all the guests and dist<strong>in</strong>guished speakers to this year’s Hospital AuthorityConvention, and to congratulate the Hospital Authority on its success <strong>in</strong> promot<strong>in</strong>g quality healthcare <strong>in</strong> ourcommunity.Through this renowned annual Convention, we are pleased to share our healthcare experiences with othercountries and regions and to learn from the experiences of other places <strong>in</strong> tackl<strong>in</strong>g modern day medicalchallenges.The theme of this year’s Convention: “Consolidat<strong>in</strong>g HealthcAre”, underscores the importance of apartnership approach to healthcare development, <strong>in</strong>clud<strong>in</strong>g the close partnership between the HospitalAuthority and HKSAR Government.Br<strong>in</strong>g<strong>in</strong>g together local and <strong>in</strong>ternational healthcare experts, this Convention offers an excellent opportunityto enhance professional networks and <strong>in</strong>tersectoral collaboration ultimately lead<strong>in</strong>g to advances <strong>in</strong> medicalknowledge, technology and techniques.I wish this year’s Convention a great success and our visitors a very enjoyable stay <strong>in</strong> Hong Kong.CY LEUNGChief ExecutiveHong Kong Special Adm<strong>in</strong>istrative Region
7Message fromSecretary for Food and HealthThe Government of the Hong KongSpecial Adm<strong>in</strong>istrative RegionHOSPITAL AUTHORITY CONVENTION 2013On its 23rd anniversary, I am delighted to offer the Hospital Authority my warmest congratulations.More than two decades ago, the establishment of the Hospital Authority embarked on a new era ofhealthcare system <strong>in</strong> Hong Kong. As the provider of public healthcare services, the Hospital Authority is<strong>in</strong>strumental <strong>in</strong> the protection and promotion of the well-be<strong>in</strong>g of people <strong>in</strong> our city. Today, Hong Kong isrenowned for its world-class public healthcare system. This well-deserved reputation is undoubtedly theresult of the concerted effort of our healthcare professionals, academics and adm<strong>in</strong>istrators, and I wish totake this opportunity to express my heartfelt gratitude to them.The Government of the Hong Kong Special Adm<strong>in</strong>istrative Region will cont<strong>in</strong>ue to render unwaver<strong>in</strong>gsupport for the Hospital Authority. In addition to the allocation of necessary resources for the pursuit ofvarious hospital development and redevelopment projects, enhancement of manpower, advanced medicaltechnology and equipment, we will also closely work with the Hospital Authority on a wide array of <strong>in</strong>itiatives<strong>in</strong> our common quest for the betterment of our medical services and healthcare system.As always, the Hospital Authority Convention offers an <strong>in</strong>valuable opportunity to people who care aboutour healthcare system and services to exchange and share with each other our new <strong>in</strong>sights, and tobe enlightened by pioneers and experts from around the world. The theme of this year’s Convention,‘Consolidat<strong>in</strong>g HealthcAre’, highlights our common mission as we together will jo<strong>in</strong> hands to tackle thechallenges ahead.I wish the Hospital Authority Convention 2013 every success and all participants an <strong>in</strong>spirational experience.KO W<strong>in</strong>g-manSecretary for Food and HealthFood and Health BureauThe Government of the Hong Kong Special Adm<strong>in</strong>istrative Region
8HOSPITAL AUTHORITY CONVENTION 2013Message fromChairmanHospital Authority, Hong KongOn behalf of the Hospital Authority, I am pleased to welcome all attendees to the Hospital AuthorityConvention 2013.From a very modest beg<strong>in</strong>n<strong>in</strong>g <strong>in</strong> 1993, this annual Convention has developed to become a signature eventthat attracts an impressive roster of lead<strong>in</strong>g healthcare practitioners, researchers, adm<strong>in</strong>istrators and policymakers from around the world. We are delighted that the Convention’s reputation and status cont<strong>in</strong>ues togrow – as evidenced <strong>in</strong> part by the record number of <strong>in</strong>dividuals who will attend this year.The pace of change <strong>in</strong> the healthcare sector cont<strong>in</strong>ues to accelerate. In common with many othereconomically advanced cities <strong>in</strong> the world, Hong Kong is striv<strong>in</strong>g to provide world-class medical services<strong>in</strong> the face of major social and environmental issues <strong>in</strong>clud<strong>in</strong>g an ag<strong>in</strong>g population, ris<strong>in</strong>g costs, escalat<strong>in</strong>g<strong>in</strong>cidence of chronic non-communicable diseases, and recurr<strong>in</strong>g threat of global pandemics and climatechange. Ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g our lead<strong>in</strong>g position <strong>in</strong> this complex and rapidly evolv<strong>in</strong>g operat<strong>in</strong>g environment requiresa firm commitment to excellence at every step of the healthcare process.It is gratify<strong>in</strong>g that the HA Convention is facilitat<strong>in</strong>g the discussions and professional development thatis essential to effectively meet the many challenges we face. In particular, by provid<strong>in</strong>g a forum to learnfrom and share with em<strong>in</strong>ent experts and practitioners work<strong>in</strong>g <strong>in</strong> a wide range of medical discipl<strong>in</strong>es, theConvention also plays a valuable role <strong>in</strong> our efforts to strengthen and enhance our systems and processes <strong>in</strong>public hospitals, as well as <strong>in</strong> promot<strong>in</strong>g the shar<strong>in</strong>g of new knowledge and ideas on approaches to modernhealthcare services and plann<strong>in</strong>g <strong>in</strong> the Authority.I wish to take this opportunity to thank our speakers for shar<strong>in</strong>g their knowledge and experience <strong>in</strong> service ofour common goal of achiev<strong>in</strong>g healthcare excellence.I must also express my deep gratitude to Mr Sun Zhi-gang, Vice M<strong>in</strong>ister of National Health and FamilyPlann<strong>in</strong>g Commission of the People’s Republic of Ch<strong>in</strong>a; Mr CY Leung, Chief Executive of the HongKong Special Adm<strong>in</strong>istrative Region; and Dr Ko W<strong>in</strong>g-man, Secretary for Food and Health of the HongKong Special Adm<strong>in</strong>istrative Region Government for their k<strong>in</strong>d support <strong>in</strong> officiat<strong>in</strong>g at the open<strong>in</strong>g of theConvention.I look forward to participat<strong>in</strong>g <strong>in</strong> this unparalleled opportunity for generat<strong>in</strong>g new ideas about how we canwork together to enhance health for all. I am sure this year’s participants will end the Convention withenriched medical knowledge, new professional contacts and excellent memories.Anthony TY WUChairmanHospital Authority, Hong Kong
9Message fromChief ExectiveHospital Authority, Hong KongHOSPITAL AUTHORITY CONVENTION 2013I wish to offer all attendees a warm welcome to our Hospital Authority Convention.Hong Kong is small <strong>in</strong> size but cosmopolitan <strong>in</strong> character. In addition to be<strong>in</strong>g home for seven million people,it is an important <strong>in</strong>ternational hub for travel and trade. This highly open nature is a key part of our city’sappeal and economic success, but it also <strong>in</strong>creases our vulnerability with respect to the transmission andspread of a wide variety of <strong>in</strong>fectious diseases. As a primary provider of medical services <strong>in</strong> Hong Kong, theHospital Authority is on the frontl<strong>in</strong>es <strong>in</strong> tackl<strong>in</strong>g public health challenges.The annual HA Convention offers our healthcare practitioners a valuable opportunity to engage <strong>in</strong> extendeddialogue and discussion with em<strong>in</strong>ent experts from across the globe and to equip themselves with the latestmedical knowledge and skills. The theme of this year’s Convention – ‘Consolidat<strong>in</strong>g HealthcAre’ underscoresthe importance of explor<strong>in</strong>g ways to enhance collaboration among different healthcare professions, partnersand stakeholders <strong>in</strong> the delivery of quality medical services. The Convention will also focus on the subthemesof Susta<strong>in</strong><strong>in</strong>g Quality Healthcare Services, Partner<strong>in</strong>g for Healthcare, Utilis<strong>in</strong>g Healthcare Resources,Modernis<strong>in</strong>g Healthcare, and Ensur<strong>in</strong>g Emergency Preparedness. Other feature programmes <strong>in</strong>clude Ch<strong>in</strong>aHealthcare, Medical Leadership, Engag<strong>in</strong>g Staff for Performance, New Models of Healthcare DeliverySystems, and many other professional topics.The Convention’s success <strong>in</strong> help<strong>in</strong>g to advance healthcare development has seen it grow <strong>in</strong> size and scopeover the past two decades. We are delighted to be welcom<strong>in</strong>g once aga<strong>in</strong> more than 4,000 attendees to theConvention. The <strong>in</strong>sights and learn<strong>in</strong>g that will result from the record 1,000-plus papers to be presented anda diverse range of <strong>in</strong>teractive panel discussions reflect the true measure of the Convention’s value and will<strong>in</strong>spire us to further enhance the high level of medical care we already provide to our population.Ma<strong>in</strong>ta<strong>in</strong><strong>in</strong>g a lead<strong>in</strong>g edge <strong>in</strong> today’s healthcare sector requires an unwaver<strong>in</strong>g commitment to excellence atevery step; the same applies <strong>in</strong> the mak<strong>in</strong>g of this Convention. I wish to express my heartfelt gratitude to theOrganis<strong>in</strong>g Committee, Scientific <strong>Programme</strong> Committee and Convention Management Committee for theirefficiency and dedication <strong>in</strong> plann<strong>in</strong>g and execut<strong>in</strong>g this year’s Convention. My deepest thanks to all ourspeakers and guests for their vital contributions <strong>in</strong> ensur<strong>in</strong>g the Convention is an enrich<strong>in</strong>g experience for allparticipants.I wish our overseas and Ma<strong>in</strong>land delegates a wonderful stay <strong>in</strong> Hong Kong. And to all attendees – I amcerta<strong>in</strong> you will f<strong>in</strong>d this year’s HA Convention a highly reward<strong>in</strong>g and memorable experience.PY LEUNGChief ExecutiveHospital Authority, Hong Kong
10HOSPITAL AUTHORITY CONVENTION 2013Outstand<strong>in</strong>g Staff and Teams Award 2013Outstand<strong>in</strong>g Staff 傑 出 員 工Name 姓 名 Title 職 位 Hospital/Cluster 醫 院 / 聯 網Ms CHAN Lai Hung陳 麗 紅 女 士Department Operations Queen Elizabeth HospitalManager (Ambulatory Care (Kowloon Central Cluster)Centre & General Outpatient 伊 利 沙 伯 醫 院Cl<strong>in</strong>ic)( 九 龍 中 醫 院 聯 網 )部 門 運 作 經 理( 日 間 醫 療 中 心 及 普 通 科 門 診 )Dr LAU Pui Yau婁 培 友 醫 生Consultant (Orthopaedics &Traumatology)顧 問 醫 生 ( 骨 科 及 創 傷 科 )United Christian Hospital(Kowloon East Cluster)基 督 教 聯 合 醫 院( 九 龍 東 醫 院 聯 網 )Ms MAK Suk Han Anna麥 淑 嫻 女 士Radiographer I In-charge放 射 治 療 師 主 管The Duchess of Kent Children’sHospital at Sandy Bay(Hong Kong West Cluster)大 口 環 根 德 公 爵 夫 人 兒 童 醫 院( 港 島 西 醫 院 聯 網 )Mr SHUM Lai HimKenneth沈 禮 謙 先 生Artisan (Physiotherapy)技 工 ( 物 理 治 療 )Tuen Mun Hospital(New Territories West Cluster)屯 門 醫 院 ( 新 界 西 醫 院 聯 網 )Ms SIU Kam Sau Kitty蕭 錦 綉 女 士Ward Manager (PatientService)病 房 經 理 ( 病 人 服 務 )Pr<strong>in</strong>cess Margaret Hospital(Kowloon West Cluster)瑪 嘉 烈 醫 院 ( 九 龍 西 醫 院 聯 網 )Mr SO Wai Sang Oliver蘇 偉 生 先 生Registered Nurse (Psychiatry)註 冊 護 士 ( 精 神 科 )Kwai Chung Hospital(Kowloon West Cluster)葵 涌 醫 院 ( 九 龍 西 醫 院 聯 網 )
Outstand<strong>in</strong>g Teams 傑 出 團 隊Name of Team 團 隊 名 稱Outstand<strong>in</strong>g Staff and Teams Award 2013Cl<strong>in</strong>ical Data Analysis and Report<strong>in</strong>g System (CDARS)Team「 臨 床 資 料 分 析 系 統 」 團 隊Healthcare Food Service Team, Pamela Youde NethersoleEastern Hospital東 區 尤 德 夫 人 那 打 素 醫 院 醫 療 膳 食 團 隊Hospital/Cluster 醫 院 / 聯 網Hospital Authority Head Office醫 管 局 總 辦 事 處Pamela Youde NethersoleEastern Hospital (Hong KongEast Cluster)東 區 尤 德 夫 人 那 打 素 醫 院( 港 島 東 醫 院 聯 網 )11HOSPITAL AUTHORITY CONVENTION 2013Hong Kong Buddhist Hospital Jo<strong>in</strong>t Replacement Centre香 港 佛 教 醫 院 關 節 置 換 中 心Hong Kong Buddhist Hospital(Kowloon Central Cluster)香 港 佛 教 醫 院( 九 龍 中 醫 院 聯 網 )Kowloon East Cluster Cataract Consortium九 龍 東 白 內 障 醫 療 團 隊Kowloon East Cluster九 龍 東 醫 院 聯 網New Territories East Cluster Medication SafetyEnhancement Team (Nurs<strong>in</strong>g)新 界 東 醫 院 聯 網 藥 物 安 全 促 進 小 組 ( 護 理 )New Territories East Cluster新 界 東 醫 院 聯 網
12HOSPITAL AUTHORITY CONVENTION 2013Outstand<strong>in</strong>g Staff and Teams Award 2013Merit Staff 優 異 員 工Name 姓 名 Title 職 位 Hospital/Cluster 醫 院 / 聯 網Dr CHAU Ka Foon周 嘉 歡 醫 生Ms POON Ka Man潘 嘉 雯 女 士Consultant (Medic<strong>in</strong>e)顧 問 醫 生 ( 內 科 )Advanced Practice Nurse(Tuberculosis and ChestMedic<strong>in</strong>e)資 深 護 師 ( 結 核 及 胸 肺 內 科 )Queen Elizabeth Hospital(Kowloon Central Cluster)伊 利 沙 伯 醫 院 ( 九 龍 中 醫 院 聯 網 )Grantham Hospital(Hong Kong East Cluster)葛 量 洪 醫 院 ( 港 島 東 醫 院 聯 網 )Miss SO Sui Fong蘇 瑞 芳 小 姐Clerk III (Community Nurs<strong>in</strong>gService)初 級 文 員 ( 社 康 護 理 服 務 )Kowloon Hospital(Kowloon Central Cluster)九 龍 醫 院 ( 九 龍 中 醫 院 聯 網 )Mr WONG Kam Man黄 錦 文 先 生Department Manager(Occupational Therapy)部 門 經 理 ( 職 業 治 療 )Tai Po Hospital(New Territories East Cluster)大 埔 醫 院 ( 新 界 東 醫 院 聯 網 )Merit Teams 優 異 團 隊Name of Team 團 隊 名 稱Hong Kong East Cluster Project Team for Crew ResourceManagement <strong>Programme</strong>港 島 東 醫 院 聯 網 「 優 化 醫 療 團 隊 管 理 」 項 目 團 隊Hospital/Cluster 醫 院 / 聯 網Hong Kong East Cluster港 島 東 醫 院 聯 網New Territories West Cluster Seat<strong>in</strong>g Services新 界 西 醫 院 聯 網 坐 姿 服 務New Territories West Cluster新 界 西 醫 院 聯 網Post Discharge Support Team for Children requir<strong>in</strong>gLong-term Care延 續 愛 與 關 懷 - 兒 科 家 居 特 別 護 理 支 援 隊Queen Elizabeth Hospital(Kowloon Central Cluster)伊 利 沙 伯 醫 院 ( 九 龍 中 醫 院 聯 網 )Pr<strong>in</strong>cess Margaret Hospital "We Care We Share" Team瑪 嘉 烈 醫 院 「 關 懷 至 上 、 齊 做 榜 樣 」 團 隊Pr<strong>in</strong>cess Margaret Hospital(Kowloon West Cluster)瑪 嘉 烈 醫 院 ( 九 龍 西 醫 院 聯 網 )Team of Fast Track Surgery <strong>Programme</strong>「 外 科 手 術 快 線 」 團 隊Tseung Kwan O Hospital(Kowloon East Hospital)將 軍 澳 醫 院 ( 九 龍 東 醫 院 聯 網 )
Hong Kong Convention and Exhibition Centre Floor PlansTo New W<strong>in</strong>gMa<strong>in</strong> EntranceTaxi StandConventionSecretariat RoomRegistration CounterGround Floor13HOSPITAL AUTHORITY CONVENTION 2013Up toConvention HallTheatre 1 & 2Level 1Level 2
14HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> at a GlanceWednesday, 15 May 201308:15 – 09:00 RegistrationConvention Hall09:00 – 10:15 Open<strong>in</strong>g Ceremony *Welcome Address by Mr Anthony WUSpecial Address by Mr CY LEUNGKeynote Address by Dr PY LEUNGCongratulatory Message by Mr Zhigang SUNKeynote Address by Dr WM KO10:15 – 10:45 Speed Presentations (Room 224 – 227)Tea BreakConvention Hall Theatre 1 Theatre 2 Room 22110:45 – 12:00 Plenary Session I*Plenary Session V*Special Topic I* Service Priorities and <strong>Programme</strong>s 1Susta<strong>in</strong><strong>in</strong>g Quality Healthcare Services Ensur<strong>in</strong>g Emergency PreparednessP1P512:00 – 13:15 Lunch13:15 – 14:30 Plenary Session IIPartner<strong>in</strong>g for Healthcare14:30 – 15:45 Plenary Session IIIUtilis<strong>in</strong>g Healthcare Resources*P2*P3Ch<strong>in</strong>a HealthcareST1Enhanc<strong>in</strong>g Healthcare DeliverySPP1Parallel Session 1 Special Topic II Service Priorities and <strong>Programme</strong>s 2Emergency: Are We Prepared?How We Do It?PS1Medical LeadershipST2Consolidat<strong>in</strong>g Service ProvidersParallel Session 2 Parallel Session 4 Service Priorities and <strong>Programme</strong>s 3HA Improvement InitiativesPS215:45 – 16:15 Speed Presentations (Room 224 – 227)16:15 – 17:30 Plenary Session IVModernis<strong>in</strong>gHealthcare*P4Tea BreakNew Horizons of Nurs<strong>in</strong>g PracticesPS4SPP2Consolidat<strong>in</strong>g Service ReceiversSPP3Parallel Session 3 Parallel Session 5 Service Priorities and <strong>Programme</strong>s 4Engag<strong>in</strong>g Staff forPerformancePS3Convention HallNew Horizons ofAllied Health Practices17:30 – 18:00 Celebration of Achievements of HA StaffPS5Quality and Safety <strong>in</strong>Healthcare ISPP4Thursday, 16 May 201309:00 – 10:15Convention Hall A Convention Hall B Convention Hall C Theatre 1 Theatre 2 Room 221Symposium 1Patient SafetyS1Symposium 5Modernis<strong>in</strong>g Healthcare:The Need to ChangeS5* Symposium 9 Masterclass I Special Topic IIIService Priorities and<strong>Programme</strong>s 5Creat<strong>in</strong>g ValuesS9Recent SurgicalDevelopmentsMC110:15 – 10:45 Speed Presentations (Room 224 – 227)10:45 – 12:00#Symposium 2Partner<strong>in</strong>g withPatientsS2Symposium 6Credential<strong>in</strong>g andPractice PrivilegesTea BreakNew Models of HealthcareDelivery SystemST3Quality and Safety <strong>in</strong>Healthcare IISPP5* Symposium 10 Masterclass II Special Topic IVService Priorities and<strong>Programme</strong>s 6S6Change: Why andto Where?S1012:00 – 13:15 Lunch13:15 – 14:3014:30 – 15:45#Symposium 3Maximis<strong>in</strong>gEfficiencySymposium 4Change:How?S3S4Symposium 7Partner<strong>in</strong>g withPrivateSymposium 8Optimis<strong>in</strong>gOutcomesNew Frontiers <strong>in</strong>Medic<strong>in</strong>eMC2Medical Simulation* Symposium 11 Masterclass IIICorporate ScholarshipPresentation 1S7HospitalAccreditationS11Creat<strong>in</strong>g a PositiveEnvironment: Build<strong>in</strong>g aMagnet HospitalMC3Cancer and Pa<strong>in</strong>Management Services* Symposium 12 Masterclass IVCorporate ScholarshipPresentation 2S8Partner<strong>in</strong>g withCommunityS12Toxicology Services15:45 – 16:15 Speed Presentations (Room 224 – 227)Poster View<strong>in</strong>gTea Break16:15 – 18:30 Convention HallMC4Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013ST4CS1Paediatrics and RehabilitationServicesCS2Susta<strong>in</strong>ableWorkforceSPP6Service Priorities and<strong>Programme</strong>s 7Modernisation ofHealthcareSPP7Service Priorities and<strong>Programme</strong>s 8Young HA InvestigatorsPresentationsSPP8Simultaneous Interpretation: English/Putonghua 即 時 傳 譯 : 英 文 / 普 通 話# Session conducted <strong>in</strong> Cantonese 此 節 以 廣 東 話 進 行Information as at 24 April 2013. Please check the latest directory at the venue.
09:00 – 10:15 * Open<strong>in</strong>g Ceremony<strong>Programme</strong> by DayWednesday, 15 May 2013 | Convention HallWelcome AddressMr Anthony WU, Chairman, Hospital Authority, Hong KongCongratulatory MessageMr Zhigang SUN, Vice M<strong>in</strong>ister, National Health and Family Plann<strong>in</strong>g Commission, The People’s Republic of Ch<strong>in</strong>aSpecial AddressMr CY LEUNG, Chief Executive, Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr WM KO, Secretary for Food and Health, The Government of the Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr PY LEUNG, Chief Executive, Hospital Authority, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)15HOSPITAL AUTHORITY CONVENTION 2013Tea Break10:45 – 12:00 * Plenary Session I – Susta<strong>in</strong><strong>in</strong>g Quality Healthcare Services P1Chairperson: Prof Raymond LIANGHospital Authority Board Member, Hong KongP1.1 Sav<strong>in</strong>g Healthcare: Susta<strong>in</strong><strong>in</strong>g High Quality Healthcare ServicesMr Jim EASTON, Manag<strong>in</strong>g Director, Care UK, UKP1.2 Patient Safety and Human FactorsDr Elizabeth HAXBY, Lead Cl<strong>in</strong>ician <strong>in</strong> Cl<strong>in</strong>ical Risk, Quality and Safety Department, Royal Brompton and Harefield NHSFoundation Trust, UK12:00 – 13:15 Lunch13:15 – 14:30 * Plenary Session II – Partner<strong>in</strong>g for Healthcare P2Chairperson: Mr YK CHENGHospital Authority Board Member, Hong KongP2.1 Globalisation and Change Management of Healthcare DeliveryMr Vishal BALI, Group Chief Executive Officer, Fortis Healthcare Limited, S<strong>in</strong>gaporeP2.2 Public-Private Collaboration: A Successful Case <strong>in</strong> AustraliaDr David J. RUSSELL-WEISZ, Chief Executive, Fiona Stanley Hospital Commission<strong>in</strong>g, Australia14:30 – 15:45 * Plenary Session III – Utilis<strong>in</strong>g Healthcare Resources P3Chairperson: Prof SP LEEHospital Authority Board Member, Hong KongP3.1 USA Healthcare Reform: Early Lessons from Accountable Care OrganisationsProf Stephen SHORTELL, Dean, School of Public Health, University of California – Berkeley, USAP3.2 Australian Healthcare ReformProf Christ<strong>in</strong>e BENNETT, Dean, School of Medic<strong>in</strong>e, The University of Notre Dame Australia, Australia15:45 – 16:15 Speed Presentations (Room 224–227)Tea Break16:15 – 17:30 * Plenary Session IV – Modernis<strong>in</strong>g Healthcare P4Chairperson: Prof KL CHANHospital Authority Board Member, Hong KongP4.1 Ambulatory Care ModelMr Andrew STRIPP, Chief Operat<strong>in</strong>g Officer and Deputy Chief Executive, Alfred Health, AustraliaP4.2 Resources Plann<strong>in</strong>g for Healthcare – Operational Delivery Networks <strong>in</strong> LondonMr Alan GOLDSMAN, Director of F<strong>in</strong>ance and Deputy Chief Executive, The Royal Marsden NHS Foundation Trust, UK17:30 – 18:00 Celebration of Achievements of HA StaffSimultaneous Interpretation: English/Putonghua 即 時 傳 譯 : 英 文 / 普 通 話 Information as at 24 April 2013. Please check the latest directory at the venue.
16HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by DayWednesday, 15 May 2013 | Theatre 109:00 – 10:15 * Open<strong>in</strong>g Ceremony (Convention Hall)Welcome AddressMr Anthony WU, Chairman, Hospital Authority, Hong KongCongratulatory MessageMr Zhigang SUN, Vice M<strong>in</strong>ister, National Health and Family Plann<strong>in</strong>g Commission, The People’s Republic of Ch<strong>in</strong>aSpecial AddressMr CY LEUNG, Chief Executive, Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr WM KO, Secretary for Food and Health, The Government of the Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr PY LEUNG, Chief Executive, Hospital Authority, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break10:45 – 12:00 * Plenary Session V – Ensur<strong>in</strong>g Emergency Preparedness P5Chairperson: Dr CK LIHospital Authority Board Member, Hong KongP5.1 Diagnostic Strategy and Laboratory Preparedness <strong>in</strong> the Face of Emerg<strong>in</strong>g DiseasesDr William TONG, Consultant Virologist, Barts Health NHS Trust, UKP5.2 Structur<strong>in</strong>g the Medical Response to Major Incidents: The Power of Major Incident Medical Management and Support (MIMMS)Prof Kev<strong>in</strong> MACKWAY-JONES, Professor of Emergency Medic<strong>in</strong>e, Manchester Royal Infirmary, UKP5.3 Disaster Mental Health PreparednessDr Melissa BRYMER, Director, Terrorism and Disaster Program, National Centre for Child Traumatic Stress UCLA, USA12:00 – 13:15 Lunch13:15 – 14:30 Parallel Session 1 – Emergency: Are We Prepared? How We Do It? PS1Chairperson: Dr HW LIUDirector (Quality and Safety), Hospital Authority, Hong KongPS1.1PS1.2PS1.3Disaster Response – from Scene to HospitalMr KL SHUM, Deputy Chief Ambulance Officer, Fire Services Department, Hong KongThe HOUR <strong>in</strong> Emergency DepartmentsDr LW CHAN, Chief of Service, Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, Hong KongModernis<strong>in</strong>g Disaster Mental Health Response and RecoveryDr Melissa BRYMER, Director, Terrorism and Disaster Program, National Centre for Child Traumatic Stress UCLA, USA14:30 – 15:45 Parallel Session 2 – HA Improvement Initiatives PS2Chairperson: Dr Derrick AUHead of Human Resources, Hospital Authority, Hong KongPS2.1PS2.2PS2.3The Journey of Change for Non-emergency Ambulance Transfer Service (NEATS): From an Ombudsman Case to aModernised ServiceMr Benjam<strong>in</strong> LEE, Senior Manager (Bus<strong>in</strong>ess Support Services), Hospital Authority, Hong KongHow Information Technology Has Improved Quality and Safety of Cl<strong>in</strong>ical ServicesDr NT CHEUNG, Chief Medical Informatics Officer, Hospital Authority, Hong KongThe Road Ahead for Hospital Authority Transplant Coord<strong>in</strong>ation Service: Silver AnniversaryMs Jenny WM KOO, Advanced Practice Nurse, Transplant Coord<strong>in</strong>ation Services, Queen Mary Hospital, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Tea Break16:15 – 17:30 Parallel Session 3 – Engag<strong>in</strong>g Staff for Performance PS3Chairperson: Mr William FK CHANHospital Authority Board Member, Hong KongPS3.1PS3.2Tra<strong>in</strong><strong>in</strong>g and Support<strong>in</strong>g Managers to Improve Staff PerformanceMr Graham CLAY, Director, Grayl<strong>in</strong> Limited, AustraliaMotivat<strong>in</strong>g Staff for PerformanceMr WK LAM, Convenor of the Non-Official Members, The Executive Council, Hong Kong17:30 – 18:00 Celebration of Achievements of HA Staff (Convention Hall)Simultaneous Interpretation: English/Putonghua 即 時 傳 譯 : 英 文 / 普 通 話 Information as at 24 April 2013. Please check the latest directory at the venue.
09:00 – 10:15* Open<strong>in</strong>g Ceremony (Convention Hall)Wednesday, 15 May 2013 | Theatre 2Welcome AddressMr Anthony WU, Chairman, Hospital Authority, Hong KongCongratulatory MessageMr Zhigang SUN, Vice M<strong>in</strong>ister, National Health and Family Plann<strong>in</strong>g Commission, The People’s Republic of Ch<strong>in</strong>aSpecial AddressMr CY LEUNG, Chief Executive, Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr WM KO, Secretary for Food and Health, The Government of the Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr PY LEUNG, Chief Executive, Hospital Authority, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break<strong>Programme</strong> by Day17HOSPITAL AUTHORITY CONVENTION 201310:45 – 12:00 * Special Topic I – Ch<strong>in</strong>a Healthcare ST1Chairperson: Dr WL CHEUNGDirector (Cluster Services), Hospital Authority, Hong KongST1.1 Hospital Accreditation <strong>in</strong> Ma<strong>in</strong>land Ch<strong>in</strong>aDr. ZHOU Jun, Deputy Director-General, Department of Medical Service Surveillance and Management, National Healthand Family Plann<strong>in</strong>g Commission, The People’s Republic of Ch<strong>in</strong>aST1.2 The Position<strong>in</strong>g and Development of Integrated Traditional Ch<strong>in</strong>ese and Western Medic<strong>in</strong>e Hospitals <strong>in</strong> Ma<strong>in</strong>land Ch<strong>in</strong>aDr Ercheng JIN, Deputy Director-General, Department of Medical Adm<strong>in</strong>istration, State Adm<strong>in</strong>istration of Traditional Ch<strong>in</strong>eseMedic<strong>in</strong>e, The People’s Republic of Ch<strong>in</strong>a12:00 – 13:15 Lunch13:15 – 14:30 Special Topic II – Medical Leadership ST2Chairperson: Dr Donald KT LIPresident, Hong Kong Academy of Medic<strong>in</strong>e, Hong KongST2.1ST2.2Lead<strong>in</strong>g Change <strong>in</strong> Health Systems: The Y<strong>in</strong> and Yang of Medical LeadershipProf Graham DICKSON, Professor Emeritus, School of Leadership Studies, Royal Roads University, CanadaDelivery Science and the Future of Healthcare LeadershipDr Albert G. MULLEY, Director, The Dartmouth Centre for Health Care Delivery Science, Dartmouth College, USA14:30 – 15:45 Parallel Session 4 – New Horizons of Nurs<strong>in</strong>g Practices PS4Moderator: Ms Jane WH LIUChief Manager (Nurs<strong>in</strong>g), Hospital Authority, Hong KongPanel Discussion: The Roles and Challenges of Nurse Consultant <strong>in</strong> Hong KongPS4.1 Multi-discipl<strong>in</strong>ary Case Management Model for People with Severe Mental IllnessMs Jolene MUI, Nurse Consultant, Community Psychiatric Service, Castle Peak Hospital, Hong KongPS4.2 Emerg<strong>in</strong>g Roles of Nurse Consultant <strong>in</strong> Cont<strong>in</strong>ence CareMs Becky SK CHAN, Nurse Consultant, Cont<strong>in</strong>ence Care Service, United Christian Hospital, Hong KongPS4.3 The Roles and Challenges of Wound Nurse Consultant <strong>in</strong> Hong KongMs WK LEE, Nurse Consultant, Department of Surgery, Queen Mary Hospital, Hong KongPS4.4 Shar<strong>in</strong>g of the Nurse Consultant Role <strong>in</strong> Emergency Care ServiceMs Joseph<strong>in</strong>e CHUNG, Nurse Consultant (Emergency Care), Accident and Emergency Department, Pr<strong>in</strong>ce of Wales Hospital, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Tea Break16:15 – 17:30 Parallel Session 5 – New Horizons of Allied Health Practices PS5Moderator: Ms Ivis WY CHUNGChief Manager (Allied Health), Hospital Authority, Hong KongPanel Discussion: The Roles and Challenges of Allied Health Consultant <strong>in</strong> Hong KongPS5.1 Roles and Challenges of Diagnostic Radiographer Consultant <strong>in</strong> Hong KongDr Stella SY HO, Consultant Radiographer (Ultrasound), Department of Imag<strong>in</strong>g and Interventional Radiology, Pr<strong>in</strong>ce of WalesHospital, Hong KongPS5.2 New Roles of Occupational Therapist <strong>in</strong> Mental Health Service – Enhanc<strong>in</strong>g Access to Psychological Interventions forPeople with Common Mental DisordersMs Joseph<strong>in</strong>e LY LEE, Consultant Occupational Therapist, Occupational Therapy Department, Pr<strong>in</strong>ce of Wales Hospital,Hong KongPS5.3 Musculoskeletal Physiotherapy ServiceMs Susane SF KWONG, Consultant Physiotherapist (Musculoskeletal), Physiotherapy Department, Ruttonjee and Tang ShiuK<strong>in</strong> Hospitals, Hong KongPS5.4 Consultant Physiotherapist <strong>in</strong> Musculoskeletal: Experience Shar<strong>in</strong>g from Pr<strong>in</strong>ce of Wales HospitalMs Angel<strong>in</strong>a KC YEUNG, Consultant Physiotherapist (Musculoskeletal), Physiotherapy Department, Pr<strong>in</strong>ce of Wales Hospital, Hong Kong17:30 – 18:00 Celebration of Achievements of HA Staff (Convention Hall)Simultaneous Interpretation: English/Putonghua 即 時 傳 譯 : 英 文 / 普 通 話 Information as at 24 April 2013. Please check the latest directory at the venue.
18HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by DayWednesday, 15 May 2013 | Room 22109:00 – 10:15 * Open<strong>in</strong>g Ceremony (Convention Hall)Welcome AddressMr Anthony WU, Chairman, Hospital Authority, Hong KongCongratulatory MessageMr Zhigang SUN, Vice M<strong>in</strong>ister, National Health and Family Plann<strong>in</strong>g Commission, The People’s Republic of Ch<strong>in</strong>aSpecial AddressMr CY LEUNG, Chief Executive, Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr WM KO, Secretary for Food and Health, The Government of the Hong Kong Special Adm<strong>in</strong>istrative RegionKeynote AddressDr PY LEUNG, Chief Executive, Hospital Authority, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break10:45 – 12:00 Enhanc<strong>in</strong>g Healthcare Delivery SPP1Chairpersons: Prof Joyce FITZPATRICKProfessor, Nurs<strong>in</strong>g Department, Case Western Reserve University, USADr Libby LEEChief Manager (Strategy, Service Plann<strong>in</strong>g and Knowledge Management), Hospital Authority, Hong KongSPP1.1 Effectiveness of a Structured Physical Rehabilitation <strong>Programme</strong> for Ch<strong>in</strong>ese Population with Depressive Disorders/CHAU RMW et al.SPP1.2 Development of a Regional Intensive Care Unit (ICU) Database for Longitud<strong>in</strong>al ICU Performance Monitor<strong>in</strong>g:Summary and the Way Forward/CHEUNG LYS et al.SPP1.3 Nurse Initiated Sequential Compression Device Application <strong>Programme</strong> for Total Knee Replacement Patient/CHEUNG SS et al.SPP1.4 The Outcomes of Ambulatory Electrocardiography (AECG or Holter) Performed for Patients with Symptoms Related toCardiac Arrhythmia <strong>in</strong> the Primary Care: A Case Series Report/CHIANG LK et al.SPP1.5 Impact on Further Utilisation of Hospital Services Among Discharged Frail Elders — an Evaluation of Integrated Care andDischarge Support Service <strong>in</strong> Kowloon Central Cluster/MAK YF et al.SPP1.6 Multi-modal Strategy for Improv<strong>in</strong>g Hand Hygiene Compliance In Intensive Care Unit/NG WYG et al.SPP1.7 Optimis<strong>in</strong>g Patient Flow as a Way of Improv<strong>in</strong>g Health Service <strong>in</strong> a Low Risk Obstetric Cl<strong>in</strong>ic/ONG CYT et al.12:00 – 13:15 Lunch13:15 – 14:30 Consolidat<strong>in</strong>g Service Providers SPP2Chairpersons: Prof Emily CHANAssociate Professor, The Jockey Club School of Public Health and Primary Care, The Ch<strong>in</strong>ese University of Hong KongDr Nelson MS WATHospital Chief Executive, Kwong Wah Hospital and TWGHs Wong Tai S<strong>in</strong> Hospital, Hong KongSPP2.1 Achiev<strong>in</strong>g Susta<strong>in</strong>able and Significant Reduction <strong>in</strong> Methicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA) Bacteremia RatesOver Five Years <strong>in</strong> a Major Acute General Hospital: A Multi-level Strategic Approach/LAM BHS et al.SPP2.2 Enhancement <strong>Programme</strong> on Quality Care Integrated with Life Education Workshop for Healthcare Assistants (HCAs)/LIU SY et al.SPP2.3 Multi-discipl<strong>in</strong>ary Home Mechanical Ventilation (HMV) <strong>Programme</strong> for Patients with Neuromuscular Diseases (NMD) <strong>in</strong>Queen Elizabeth Hospital (QEH)/NG CK et al.SPP2.4 Collaborative Multi-discipl<strong>in</strong>ary Approach to Enhance Quality Care for Chronic Obstructive Pulmonary Disease (COPD)Patients <strong>in</strong> Primary Care/NG L et al.SPP2.5 A Life Review Project for Term<strong>in</strong>ally Ill Palliative Care Patients Under Care of Cl<strong>in</strong>ical Oncology Department/SHIU CKS et al.SPP2.6SPP2.7Multi-discipl<strong>in</strong>ary Input for Discharge Management <strong>in</strong> Hong Kong Buddhist Hospital (HKBH)/TAM KF et al.Evaluation of the Oncology Pharmacists’ Therapeutic Recommendations <strong>in</strong> the Oncology Wards and Cl<strong>in</strong>ics at Pr<strong>in</strong>cessMargaret Hospital/YIP EYT et al.14:30 – 15:45 Consolidat<strong>in</strong>g Service Receivers SPP3Chairpersons: Dr William TONGConsultant Virologist, Barts Health NHS Trust, UKDr David TY LAMHospital Chief Executive, Ruttonjee and Tang Shiu K<strong>in</strong> Hospitals and Tung Wah Eastern Hospital, Hong KongSPP3.1 The Effectiveness of an Enhancement <strong>Programme</strong> on Management of Febrile Neutropenia <strong>in</strong> Haematology/AU KK et al.SPP3.2 The Impact of Teach<strong>in</strong>g Illness Management to Psychiatric Inpatients: A One Year Follow-up/CHAO JYW et al.SPP3.3 Innovative Approach of Enhanc<strong>in</strong>g Patient Education Us<strong>in</strong>g “Diabetes Conversation Map” to Improve Outcome and Insul<strong>in</strong>Commencement <strong>in</strong> General Outpatient Cl<strong>in</strong>ic (GOPC), Hong Kong East Cluster/WONG YF et al.SPP3.4 Effectiveness of the Trivalent Seasonal Influenza Vacc<strong>in</strong>e of Hong Kong Institutionalised Elderly: A 12-month RetrospectiveCohort Study/LAW TC et al.SPP3.5 New Paradigm <strong>in</strong> Manag<strong>in</strong>g Patients with Chronic Illness through Patient Engagement/HO SS et al.SPP3.6 Report of Pilot Empowerment <strong>Programme</strong> for Pakistani Diabetics/NG MP et al.SPP3.7 Multi-discipl<strong>in</strong>ary Supported Discharge <strong>Programme</strong> for Stroke Patients <strong>in</strong> Our Lady of Maryknoll Hospital (OLMH)/LAU ST et al.15:45 – 16:15 Speed Presentations (Room 224–227)Tea Break16:15 – 17:30 Quality and Safety <strong>in</strong> Healthcare I SPP4Chairpersons: Dr Ian CURRANDean of Educational Excellence, Health of Innovation, London Deanery, NHS London, UKDr Hobby CHEUNGHospital Chief Executive, Kowloon Hospital and Hong Kong Eye Hospital, Hong KongSPP4.1 Wiser Project <strong>in</strong> Streaml<strong>in</strong><strong>in</strong>g Delivery Process of Three-Litre Normal Sal<strong>in</strong>e Irrigation Fluid/CHAN PT et al.SPP4.2 Domiciliary Non-<strong>in</strong>vasive Ventilation Service for Patients with Chronic Respiratory Failure/CHAN YY et al.SPP4.3 Cardiopulmonary Bypass — an Evidence-based Change of Practice/FUNG SH et al.SPP4.4 Enhancement <strong>in</strong> Radiotherapy Treatment for Breast Cancer Patients: From One-by-one to Cont<strong>in</strong>uous/WONG KLA et al.SPP4.5 Innovative Lymphedema Management <strong>Programme</strong> (LMP) <strong>in</strong> Tung Wah Hospital (TWH) for Breast Cancer Patients toImprove Service Efficiency and Effectiveness/LEUNG SY et al.SPP4.6 Protocol Driven Assessment <strong>Programme</strong> Effectively Shortens New Case Wait<strong>in</strong>g Time/LEUNG SK et al.SPP4.7 Ten-po<strong>in</strong>t System of Pr<strong>in</strong>cess Margaret Hospital Cardiac Intervention Centre/TSUI PT et al.17:30 – 18:00 Celebration of Achievements of HA Staff (Convention Hall)Information as at 24 April 2013. Please check the latest directory at the venue.
<strong>Programme</strong> by DayThursday, 16 May 2013 | Convention Hall A09:00 – 10:15 Symposium 1 – Patient Safety S1Chairperson: Dr Albert LOCluster Chief Executive, New Territories West Cluster, Hospital Authority, Hong KongS1.1 Quality Healthcare: Cultural Change for Quality, Patient Safety and ValueMr Jim EASTON, Manag<strong>in</strong>g Director, Care UK, UKS1.2 Cl<strong>in</strong>ical Risk ManagementDr Elizabeth HAXBY, Lead Cl<strong>in</strong>ician <strong>in</strong> Cl<strong>in</strong>ical Risk, Quality and Safety Department, Royal Brompton and Harefield NHSFoundation Trust, UKS1.3 Procedural Sedation: Challenges and OpportunitiesDr YF CHOW, Chief of Service, Department of Anaesthesiology and Operat<strong>in</strong>g Theatre Services, Queen Elizabeth Hospital,Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)19HOSPITAL AUTHORITY CONVENTION 2013Tea Break10:45 – 12:00 # Symposium 2 – Partner<strong>in</strong>g with Patients S2Moderator:Mr CF TSEJournalist, Radio Television Hong Kong, Hong KongHospital Authority City Forum – Partner<strong>in</strong>g with PatientsDiscussion Panel Members:Mr KP TSANG, Chairman, Alliance for Patients’ Mutual Help Organisation, Hong KongDr KP LEUNG, Chairperson, Public Advisory Group, Queen Elizabeth Hospital, Hong KongMs Lisa SW YIP, Member, Public Compla<strong>in</strong>ts Committee, Hospital Authority, Hong KongDr Daisy DAI, Chief Manager (Primary and Community Services), Hospital Authority, Hong KongDr Seamus YL SIU, Resident, Intensive Care Unit, Pr<strong>in</strong>cess Margaret Hospital, Hong KongMs YL WONG, Ward Manager, Department of Medic<strong>in</strong>e and Therapeutics, Pr<strong>in</strong>ce of Wales Hospital, Hong Kong12:00 – 13:15 Lunch13:15 – 14:30 # Symposium 3 – Maximis<strong>in</strong>g Efficiency S3Moderator:Dr FUNG HongCluster Chief Executive, New Territories East Cluster, Hospital Authority, Hong KongHospital Authority City Forum – Next Step <strong>in</strong> Community CareDiscussion Panel Members:Dr KL CHOO, Consultant, Medic<strong>in</strong>e Department, North District Hospital, Hong KongDr Elsie HUI, Chief of Service, Medical and Geriatrics Department, Shat<strong>in</strong> Hospital, Hong KongDr KS CHAN, Chief of Service, Department of Medic<strong>in</strong>e, Haven of Hope Hospital, Hong KongDr CP WONG, Service Director (Primary and Community Healthcare), Hong Kong East Cluster, Hong KongMs May CHAN, Kowloon West Cluster Department Operations Manager (Community Nurs<strong>in</strong>g Service and Community Health),Hospital Authority, Hong Kong14:30 – 15:45 Symposium 4 – Change: How? S4Chairperson: Prof Maurice KH YAPHospital Authority Board Member, Hong KongS4.1 Introduc<strong>in</strong>g High Volume Cataract Surgery <strong>in</strong> Hong Kong: Improv<strong>in</strong>g Surgeon Efficiency Without Sacrific<strong>in</strong>g Patient SafetyProf David WONG, Chief of Service, Department of Ophthalmology, Queen Mary Hospital, Hong KongS4.2 Prerequisite for Ambulatory Day TonsillectomyDr Victor ABDULLAH, Chief of Service, Department of Ear, Nose and Throat, United Christian Hospital, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Poster View<strong>in</strong>gTea BreakConvention Hall16:15 – 18:30 Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013# Session conducted <strong>in</strong> Cantonese 此 節 以 廣 東 話 進 行 Information as at 24 April 2013. Please check the latest directory at the venue.
20HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by DayThursday, 16 May 2013 | Convention Hall B09:00 – 10:15* Symposium 5 – Modernis<strong>in</strong>g Healthcare: The Need to ChangeChairperson: Dr Joseph LUICluster Chief Executive, Kowloon East Cluster, Hospital Authority, Hong KongS5.1 Impacts of an Age<strong>in</strong>g Population: Way Forward for Health and Social CareProf Alfred CM CHAN, Chair Professor, Asia-Pacific Institute of Age<strong>in</strong>g Studies, L<strong>in</strong>gnan University; Chairman, ElderlyCommission, Hong KongS5.2 Tackl<strong>in</strong>g Complex Chronic Conditions – Apply What We Already KnowProf Gabriel LEUNG, Head, Department of Community Medic<strong>in</strong>e, The University of Hong Kong, Hong KongS5.3 Challenges Ahead <strong>in</strong> Healthcare ManagementDr SV LO, Director (Strategy and Plann<strong>in</strong>g), Hospital Authority, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)Tea BreakS510:45 – 12:00* Symposium 6 – Credential<strong>in</strong>g and Practice PrivilegesS6Chairperson: Dr CT HUNGCluster Chief Executive, Kowloon Central Cluster, Hospital Authority, Hong KongS6.1 Credential<strong>in</strong>g: Perspectives from the AcademyProf CS LAU, Chair Professor, Department of Medic<strong>in</strong>e, Queen Mary Hospital, Hong KongS6.2 Early Steps along Credential<strong>in</strong>g <strong>in</strong> Hong Kong – Experience of a College and Private Hospital OrganiserDr Ares KL LEUNG, Deputy Medical Director, Union Hospital, Hong KongS6.3 Credential<strong>in</strong>g of Doctors <strong>in</strong> Private HospitalDr Joseph WT CHAN, Deputy Medical Super<strong>in</strong>tendent, Hong Kong Sanatorium and Hospital, Hong Kong12:00 – 13:15 Lunch13:15 – 14:30* Symposium 7 – Partner<strong>in</strong>g with PrivateS7Chairperson: Dr CC LUKCluster Chief Executive, Hong Kong West Cluster, Hospital Authority, Hong KongS7.1 Public-Private Partnerships <strong>in</strong> HealthcareMr Vishal BALI, Group Chief Executive Officer, Fortis Healthcare Limited, S<strong>in</strong>gaporeS7.2 The Australian Experience: The Public-Private Partnership (PPP)Dr David J. RUSSELL-WEISZ, Chief Executive, Fiona Stanley Hospital Commission<strong>in</strong>g, Australia14:30 – 15:45* Symposium 8 – Optimis<strong>in</strong>g OutcomesS8Chairperson: Mrs Yvonne LAWHospital Authority Board Member, Hong KongS8.1 Measur<strong>in</strong>g Performance: Emergency Department and Surgery Wait<strong>in</strong>g Time Targets <strong>in</strong> AustraliaProf Christ<strong>in</strong>e BENNETT, Dean, School of Medic<strong>in</strong>e, University of Notre Dame Australia, AustraliaS8.2 Use of Casemix <strong>in</strong> Cl<strong>in</strong>ical Outcome ManagementDr Deacons YEUNG, Chief Manager (F<strong>in</strong>ancial Plann<strong>in</strong>g), Hospital Authority, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Poster View<strong>in</strong>gTea BreakConvention Hall16:15 – 18:30 Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013Simultaneous Interpretation: English/Putonghua 即 時 傳 譯 : 英 文 / 普 通 話 Information as at 24 April 2013. Please check the latest directory at the venue.
<strong>Programme</strong> by DayThursday, 16 May 2013 | Convention Hall C09:00 – 10:15 Symposium 9 – Creat<strong>in</strong>g Values S9Chairperson: Mr Lester Garson HUANGHospital Authority Board Member, Hong KongS9.1 The Role of Value-based Purchas<strong>in</strong>g <strong>in</strong> United States Healthcare ReformProf Stephen SHORTELL, Dean, School of Public Health, University of California – Berkeley, USAS9.2 Evolution of Resource Allocation <strong>in</strong> Hospital Authority and the Values CreatedMs Nancy TSE, Director (F<strong>in</strong>ance), Hospital Authority, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break21HOSPITAL AUTHORITY CONVENTION 201310:45 – 12:00 Symposium 10 – Change: Why and to Where? S10Chairperson: Dr Nancy TUNGCluster Chief Executive, Kowloon West Cluster, Hospital Authority, Hong KongS10.1 Coord<strong>in</strong>ate My Care (CMC)Mr Alan GOLDSMAN, Director of F<strong>in</strong>ance and Deputy Chief Executive, The Royal Marsden NHS Foundation Trust, UKS10.2 Ambulatory Care: A Management Initiative or a Cl<strong>in</strong>ical Need?Mr Andrew STRIPP, Chief Operat<strong>in</strong>g Officer and Deputy Chief Executive, Alfred Health, AustraliaS10.3 Healthcare Service Remodell<strong>in</strong>g: Hong Kong ExperienceDr FUNG Hong, Cluster Chief Executive, New Territories East Cluster, Hospital Authority, Hong Kong12:00 – 13:15 Lunch13:15 – 14:30 Symposium 11 – Hospital Accreditation S11Chairperson: Dr Alexander CHIUChief Manager (Quality and Standards), Hospital Authority, Hong KongS11.1 Hospital Accreditation: A Private Hospital’s ExperienceDr Anthony LEE, Chairman, Hong Kong Private Hospitals Association, Hong KongS11.2 Impact of Hospital Accreditation on Public HospitalsDr CT HUNG, Cluster Chief Executive, Kowloon Central Cluster, Hospital Authority, Hong Kong14:30 – 15:45 Symposium 12 – Partner<strong>in</strong>g with Community S12Chairperson: Mr BW CHANHospital Authority Board Member, Hong KongS12.1 Partnership for Mental HealthMs Sania YAU, Chief Executive Officer, New Life Psychiatric Rehabilitation Association, Hong KongS12.2 Partner<strong>in</strong>g for Healthcare – What Can We Do for the Best of the CommunityMs Iris YP CHAN, Head, Health and Care Service Department, Hong Kong Red Cross, Hong KongS12.3 Partnership for Community Wellness – Experience Shar<strong>in</strong>g <strong>in</strong> Collaboration between the Medical andSocial Welfare SectorMr Ivan TL YIU, Community Services Secretary, Tung Wah Group of Hospitals, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Poster View<strong>in</strong>gTea BreakConvention Hall16:15 – 18:30 Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013Information as at 24 April 2013. Please check the latest directory at the venue.
22HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by DayThursday, 16 May 2013 | Theatre 109:00 – 10:15 Masterclass I – Recent Surgical Developments MC1Chairperson: Dr Theresa LIHospital Chief Executive, Bradbury Hospice and Shat<strong>in</strong> Hospital, Hong KongMC1.1 Apply<strong>in</strong>g Variable Life Adjusted Display (VLAD) <strong>in</strong> Monitor<strong>in</strong>g Surgical Operation PerformanceDr Albert WC YUEN, Chief of Service, Department of Surgery, Ruttonjee and Tang Shiu K<strong>in</strong> Hospitals, Hong KongMC1.2 Be a Happy Lady – How Urologists HelpDr HY CHEUNG, Consultant, Department of Surgery, North District Hospital, Hong KongMC1.3 Concerted Effort <strong>in</strong> Care of Female Ur<strong>in</strong>ary Incont<strong>in</strong>ence and Pelvic Organ ProlapseDr Symphorosa SC CHAN, Consultant, Obstetrics and Gynaecology Department, Pr<strong>in</strong>ce of Wales Hospital, Hong Kong10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break10:45 – 12:00 Masterclass II – New Frontiers <strong>in</strong> Medic<strong>in</strong>e MC2Chairperson: Dr TY CHUIHospital Chief Executive, Haven of Hope Hospital, Hong KongMC2.1 Percutaneous Coronary Intervention – Past, Present and FutureDr CS CHIANG, Consultant, Department of Medic<strong>in</strong>e, Queen Elizabeth Hospital, Hong KongMC2.2 Heart Transplantation and Ventricular Assist Device (VAD) TherapyDr Timmy WK AU, Chief of Service, Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong KongMC2.3 Improvement of Cure Rate <strong>in</strong> Childhood Acute Lymphoblastic Leukaemia: No New Drugs <strong>in</strong> the Past Three DecadesDr CK LI, Chief of Service, Department of Paediatrics, Pr<strong>in</strong>ce of Wales Hospital, Hong Kong12:00 – 13:15 Lunch13:15 – 14:30 Masterclass III – Creat<strong>in</strong>g a Positive Environment: Build<strong>in</strong>g a Magnet Hospital MC3Chairperson: Prof Diana TF LEEHospital Authority Board Member, Hong KongMC3.1 Build<strong>in</strong>g a Magnet Nurs<strong>in</strong>g Department: The Mount S<strong>in</strong>ai Medical Centre ExperienceDr Carol PORTER, Edgar M. Cullman, Sr. – Chair of the Department of Nurs<strong>in</strong>g; Chief Nurs<strong>in</strong>g Officer/Senior Vice President –Mount S<strong>in</strong>ai Medical Center; Associate Dean of Nurs<strong>in</strong>g Research and Education – Mount S<strong>in</strong>ai School of Medic<strong>in</strong>e,The Mount S<strong>in</strong>ai Medical Center, USAMC3.2 The Academic Perspective on Creat<strong>in</strong>g a Positive Practice EnvironmentProf Joyce FITZPATRICK, Professor, Nurs<strong>in</strong>g Department, Case Western Reserve University, USAMC3.3 Build<strong>in</strong>g a Magnet Hospital – Local PerspectiveMs Sylvia FUNG, Former Chief Manager (Nurs<strong>in</strong>g), Hospital Authority, Hong Kong14:30 – 15:45 Masterclass IV – Toxicology Services MC4Chairperson: Dr SH LIUChief Manager (Infection, Emergency and Cont<strong>in</strong>gency), Hospital Authority, Hong KongMC4.1 Outbreaks of HypoglycaemiaDr Tony MAK, Consultant Pathologist, Hospital Authority Toxicology Reference Laboratory, Hospital Authority, Hong KongMC4.2 Ongo<strong>in</strong>g Poison<strong>in</strong>g Issues <strong>in</strong> Hong KongDr Raymond SM WONG, Consultant Physician, Poison Control Centre, Department of Medic<strong>in</strong>e and Therapeutics, Pr<strong>in</strong>ce ofWales Hospital, Hong KongMC4.3 Toxico<strong>in</strong>telligence – Prepar<strong>in</strong>g for the Expected and Unexpected Poison<strong>in</strong>gsDr ML TSE, Consultant, Hong Kong Poison Information Centre, Hong KongMC4.4 The Hong Kong Poison Control Network and the Role of Department of HealthDr Albert KW AU, Senior Medical Officer, Centre for Health Protection, Department of Health, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Poster View<strong>in</strong>gTea BreakConvention Hall16:15 – 18:30 Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013Information as at 24 April 2013. Please check the latest directory at the venue.
<strong>Programme</strong> by DayThursday, 16 May 2013 | Theatre 209:00 – 10:15 Special Topic III – New Models of Healthcare Delivery System ST3Chairperson: Ms W<strong>in</strong>nie NGHospital Authority Board Member, Hong KongST3.1ST3.2Shared Decision Mak<strong>in</strong>g – Why Patients’ Preferences MatterDr Albert G. MULLEY, Director, The Dartmouth Centre for Health Care Delivery Science, Dartmouth College, USAPatients' Rights and Professional DignityMs Connie LAU, Chairperson, International Advisory Group of Experts on Consumer Protection, United Nations Conferenceon Trade and Development, United Nations10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break10:45 – 12:00 Special Topic IV – Medical Simulation ST423HOSPITAL AUTHORITY CONVENTION 2013Chairperson: Dr FC PANGChief Manager (Medical Grade), Hospital Authority, Hong KongST4.1ST4.2Innovation <strong>in</strong> Healthcare Education – Tra<strong>in</strong><strong>in</strong>g for Professional ExcellenceDr Ian CURRAN, Postgraduate Dean, Head of Innovation, London and Cl<strong>in</strong>ical Advisor to Health Education England, UKApplication of Simulators to Enhance the Tra<strong>in</strong><strong>in</strong>g of M<strong>in</strong>imal Access SurgeryDr CN TANG, Chief of Service, Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong12:00 – 13:15 Lunch13:15 – 14:30 Corporate Scholarship Presentation 1 – Cancer and Pa<strong>in</strong> Management Services CS1Chairperson: Ms Anna LEEChief Pharmacist, Hospital Authority, Hong KongCS1.1 Cancer Biology: Predictive Biomarkers for Tailored TherapiesDr CK KWAN, Associate Consultant, Cl<strong>in</strong>ical Oncology Department, Queen Elizabeth Hospital, Hong KongCS1.2 Cross-Clusters Collaborative <strong>Programme</strong> to Better Oncology Care Delivery ModelMs SS MAK, Nurse Consultant, Department of Cl<strong>in</strong>ical Oncology, Pr<strong>in</strong>ce of Wales Hospital, Hong KongCS1.3 Overseas Corporate Scholarship <strong>Programme</strong> (OCSP) for Physiotherapist <strong>in</strong> Musculoskeletal Specialty <strong>in</strong> 2011Ms Joanna MS WONG, Physiotherapist, Alice Ho Miu L<strong>in</strong>g Nethersole Hospital, Hong KongCS1.4 Provision of Oncology Pharmacy Service at Pr<strong>in</strong>cess Margaret HospitalMr Elton YT YIP, Pharmacist, Pr<strong>in</strong>cess Margaret Hospital, Hong Kong14:30 – 15:45 Corporate Scholarship Presentation 2 – Paediatrics and Rehabilitation Services CS2Chairperson: Dr Cissy YUHospital Chief Executive, Tung Wah Hospital, Hong KongCS2.1 Post Tra<strong>in</strong><strong>in</strong>g Shar<strong>in</strong>g on Hands on Cl<strong>in</strong>ical Experience of Paediatric Anaesthesia <strong>in</strong> the Children’s Hospital atWestmead (CHW)Dr Janice NG, Associate Consultant, Department of Anaesthesiology, Queen Mary Hospital, Hong KongCS2.2 Overseas Corporate Scholarship <strong>Programme</strong> 2011/12 at Children’s Hospital of Philadelphia (CHOP): Post Tra<strong>in</strong><strong>in</strong>gShar<strong>in</strong>gMs SY LEE, Nurse Consultant, Department of Paediatrics, Pr<strong>in</strong>ce of Wales Hospital, Hong KongMs SK TANG, Advanced Practice Nurse, Paediatrics and Adolescent Medic<strong>in</strong>e Department, Pr<strong>in</strong>cess Margaret Hospital,Hong KongCS2.3 Overseas Corporate Scholarship <strong>Programme</strong> for Allied Health Professionals 2011 – Attachment <strong>Programme</strong> forAllied Health Professionals <strong>in</strong> Primary and Community Care of Patients Suffer<strong>in</strong>g from Chronic Lung DiseasesMs Aileen WY CHU, Occupational Therapist, Pr<strong>in</strong>cess Margaret Hospital, Hong KongCS2.4 Overseas Paediatric Cl<strong>in</strong>ical Pharmacy Tra<strong>in</strong><strong>in</strong>g and Setup of Paediatric Satellite Pharmacy <strong>in</strong> Pr<strong>in</strong>cess MargaretHospitalMs Candy LAU, Pharmacist, Pr<strong>in</strong>cess Margaret Hospital, Hong Kong15:45 – 16:15 Speed Presentations (Room 224–227)Poster View<strong>in</strong>gTea BreakConvention Hall16:15 – 18:30 Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013Information as at 24 April 2013. Please check the latest directory at the venue.
24HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by DayThursday, 16 May 2013 | Room 22109:00 – 10:15 Quality and Safety <strong>in</strong> Healthcare II SPP5Chairpersons: Dr Carol PORTEREdgar M. Cullman, Sr. – Chair of the Department of Nurs<strong>in</strong>g; Chief Nurs<strong>in</strong>g Officer/Senior Vice President–Mount S<strong>in</strong>ai Medical Center; Associate Dean of Nurs<strong>in</strong>g Research and Education–Mount S<strong>in</strong>ai School of Medic<strong>in</strong>e,The Mount S<strong>in</strong>ai Medical Center, USADr KT TOMHospital Chief Executive, Tseung Kwan O Hospital, Hong KongSPP5.1SPP5.2SPP5.3SPP5.4SPP5.5SPP5.6SPP5.7Promot<strong>in</strong>g Evidence-based Practice <strong>in</strong> Prevent<strong>in</strong>g Methicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA) Bacteremia <strong>in</strong>Patients Hav<strong>in</strong>g Central Venous Catheter Undergo<strong>in</strong>g Haemodialysis/HO HS et al.STAR Project: Strategic Targets Aim to Reduce Haemodialysis Catheter-related Bloodstream Infection/HO LF et al.Procedural Sedation for Flexible Bronchoscopy <strong>in</strong> Grantham Hospital/FUNG SL et al.Paediatric Satellite Pharmacy <strong>in</strong> Pr<strong>in</strong>cess Margaret Hospital/YAO R et al.Effectiveness of Barcode Track<strong>in</strong>g <strong>in</strong> Document<strong>in</strong>g and Prevent<strong>in</strong>g Patient Specimen Identification Errors <strong>in</strong> AnatomicalPathology Laboratory/LEE KC et al.The Effect of Introduc<strong>in</strong>g Rout<strong>in</strong>e Use of Intracameral Cefuroxime on Post-operative Endophthalmitis <strong>in</strong> Cataract Surgery<strong>in</strong> a Ch<strong>in</strong>ese Population/LI KK et al.Positive Outcome from Implementation of Patient Safety Round by Frontl<strong>in</strong>e Staff <strong>in</strong> Surgical Department/SHE HFA et al.10:15 – 10:45 Speed Presentations (Room 224–227)Tea Break10:45 – 12:00 Susta<strong>in</strong>able Workforce SPP6Chairpersons: Mr Graham CLAYDirector, Grayl<strong>in</strong> Ltd., AustraliaMs Cecilia CHUChief Manager (Human Resources), Hospital Authority, Hong KongSPP6.1 Evidenced-based Approach to Promote Work Safe Behaviour/CHAN CL et al.SPP6.2 Staff Competency <strong>Programme</strong> <strong>in</strong> Manual Handl<strong>in</strong>g Operation (MHO) Management/CHAN Y et al.SPP6.3 Retention of Support<strong>in</strong>g Staff Start<strong>in</strong>g from Their Pre-employment/SIN YC et al.SPP6.4 Advance Measures <strong>in</strong> Promot<strong>in</strong>g Radiation Safety for Operat<strong>in</strong>g Theatre/LAM LCC et al.SPP6.5 Advanced Oncology Nurs<strong>in</strong>g Practice <strong>in</strong> Intravenous Bolus Injection of Cytotoxic Vesicants: Our 14-year Experience/LING WM et al.SPP6.6 Simulation Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Hospital Authority Central Intern Orientation <strong>Programme</strong> to Promote Patient Safety <strong>in</strong> Daily HospitalPractice/LO CCK et al.SPP6.7 Medical Records Retrieval <strong>in</strong> Ophthalmology Cl<strong>in</strong>ic (EYE OPD)/TAM WS et al.12:00 – 13:15 Lunch13:15 – 14:30 Modernisation of Healthcare SPP7Chairpersons: Prof Graham DICKSONProfessor Emeritus, School of Leadership Studies, Royal Roads University, CanadaDr WK CHINGHospital Chief Executive, The Duchess of Kent Children’s Hospital, TWGHs Fung Yiu K<strong>in</strong>g Hospital and MacLehoseMedical Rehabilitation Centre, Hong KongSPP7.1 Experience of Us<strong>in</strong>g Hydrogen Peroxide Vaporisation for Prevent<strong>in</strong>g Environmental Transmission of the Multi-drugResistant Organism – Vancomyc<strong>in</strong>-Resistant Enterococci/HO OM et al.SPP7.2 The Patient Engagement <strong>Programme</strong> <strong>in</strong> Hong Kong – The Leg Club (Review and Forward)/LAM KKA et al.SPP7.3 Transcatheter Aortic Valve Implantation (TAVI) Queen Elizabeth Hospital Registry – A Multi-discipl<strong>in</strong>ary Team Approach/LEE KYM et al.SPP7.4 Can Coat<strong>in</strong>g the Ward Environment with Visible Light Activated Photocatalyst Reduce the Hospital Acquired InfectionRate?/LEUNG HB et al.SPP7.5 First Year of 24/7 Acute Stroke Unit (ASU) and Stroke Thrombolytic Service/KWAN WMM et al.SPP7.6 See What Are Beh<strong>in</strong>d (SWAB): Four Factors Lead<strong>in</strong>g to Successful Changes <strong>in</strong> Swab Count<strong>in</strong>g Practice <strong>in</strong> Pr<strong>in</strong>ce of WalesHospital/MOK TY et al.SPP7.7 Dy<strong>in</strong>g at Home – A Cross-specialty Multi-discipl<strong>in</strong>ary Effort to Fulfill the Last Wish of Term<strong>in</strong>ally Ill Patients/NG JSC et al.14:30 – 15:45 Young HA Investigators Presentations SPP8Chairpersons: Prof Kev<strong>in</strong> MACKWAY-JONESProfessor of Emergency Medic<strong>in</strong>e, Manchester Royal Infirmary, UKDr HC MAHospital Chief Executive, Caritas Medical Centre, Hong KongSPP8.1 Pharmacist Steps to Integrated Care <strong>in</strong> High-risk Geriatrics – Ward Aged Patient Pharmacist Service (WardAPPS)/CHU KY et al.SPP8.2 Evaluation of Sk<strong>in</strong>-to-sk<strong>in</strong> Contact <strong>in</strong> Neonatal Ward from Parents’ and Nurses’ Perspectives/LO KY et al.SPP8.3 Meet<strong>in</strong>g Needs, Fill<strong>in</strong>g Gaps: An Integration of a Written Pamphlet and a Multimedia Orientation <strong>Programme</strong> to Patients toPromote Cont<strong>in</strong>uous Quality Improvement <strong>in</strong> Surgical Ward/NG YHG et al.SPP8.4 New Radiation-free Era <strong>in</strong> Reflux Imag<strong>in</strong>g for Paediatric Ur<strong>in</strong>ary Tract Infection (UTI): Void<strong>in</strong>g Urosonography withIntravesical Ultrasound Contrast – First Local Pilot Study/TSE KS et al.SPP8.5 Less is More: A Simple Chest Dra<strong>in</strong> Site Dress<strong>in</strong>g is Good Enough/WONG PSF et al.SPP8.6 Use of Water Swallow<strong>in</strong>g Test as a Screen<strong>in</strong>g Tool <strong>in</strong> Acute Stroke Unit/WONG AYH et al.SPP8.7 How Can Watch-PAT Adopt the “WIN” Strategy/YIU KC et al.15:45 – 16:15 Speed Presentations (Room 224–227)Poster View<strong>in</strong>gTea BreakConvention Hall16:15 – 18:30 Presentation of Awards and Clos<strong>in</strong>g CeremonyPresentation of Best Oral Presentation and Best Poster Display AwardsPresentation of HA Outstand<strong>in</strong>g Staff and Teams Award 2013Information as at 24 April 2013. Please check the latest directory at the venue.
SessionsCSMCPPSCorporate Scholarship PresentationsMasterclassesPlenary SessionsParallel Sessions<strong>Programme</strong> by First AuthorSSPPSTSymposiumsService Priorities and <strong>Programme</strong>sSpecial TopicsFirst Author Title Presentation Date SessionAbdullah V Prerequisite for Ambulatory Day Tonsillectomy Thursday, 16 May 2013 S4.2Au KKAu KWAThe Effectiveness of an Enhancement <strong>Programme</strong> on Management ofFebrile Neutropenia <strong>in</strong> HaematologyThe Hong Kong Poison Control Network and the Role of Department ofHealthWednesday, 15 May 2013Thursday, 16 May 2013SPP3.1MC4.425HOSPITAL AUTHORITY CONVENTION 2013Au T Heart Transplantation and Ventricular Assist Device (VAD) Therapy Thursday, 16 May 2013 MC2.2Bali V Globalisation and Change Management of Healthcare Delivery Wednesday, 15 May 2013 P2.1Bali V Public-Private Partnerships <strong>in</strong> Healthcare Thursday, 16 May 2013 S7.1Bennett C Australian Healthcare Reform Wednesday, 15 May 2013 P3.2Bennett CMeasur<strong>in</strong>g Performance: Emergency Department and Surgery Wait<strong>in</strong>gTime Targets <strong>in</strong> AustraliaThursday, 16 May 2013 S8.1Brymer M Disaster Mental Health Preparedness Wednesday, 15 May 2013 P5.3Brymer M Modernis<strong>in</strong>g Disaster Mental Health Response and Recovery Wednesday, 15 May 2013 PS1.3Chan CL Evidenced-based Approach to Promote Work Safe Behaviour Thursday, 16 May 2013 SPP6.1Chan CMAImpacts of an Age<strong>in</strong>g Population: Way Forward for Health and SocialCareThursday, 16 May 2013 S5.1Chan LW The HOUR <strong>in</strong> Emergency Departments Wednesday, 15 May 2013 PS1.2Chan PTWiser Project <strong>in</strong> Streaml<strong>in</strong><strong>in</strong>g Delivery Process of Three-Litre NormalSal<strong>in</strong>e Irrigation FluidWednesday, 15 May 2013SPP4.1Chan SCSConcerted Effort <strong>in</strong> Care of Female Ur<strong>in</strong>ary Incont<strong>in</strong>ence and PelvicOrgan ProlapseThursday, 16 May 2013MC1.3Chan SKB Emerg<strong>in</strong>g Roles of Nurse Consultant <strong>in</strong> Cont<strong>in</strong>ence Care Wednesday, 15 May 2013 PS4.2Chan WTJ Credential<strong>in</strong>g of Doctors <strong>in</strong> Private Hospital Thursday, 16 May 2013 S6.3Chan YStaff Competency <strong>Programme</strong> <strong>in</strong> Manual Handl<strong>in</strong>g Operation (MHO)ManagementThursday, 16 May 2013SPP6.2Chan YPIPartner<strong>in</strong>g for Healthcare – What Can We Do for the Best of theCommunityThursday, 16 May 2013 S12.2Chan YYDomiciliary Non-<strong>in</strong>vasive Ventilation Service for Patients with ChronicRespiratory FailureWednesday, 15 May 2013SPP4.2Chao JYWThe Impact of Teach<strong>in</strong>g Illness Management to Psychiatric In-patients: AOne Year Follow-upWednesday, 15 May 2013SPP3.2Chau RMWEffectiveness of a Structured Physical Rehabilitation <strong>Programme</strong> forCh<strong>in</strong>ese Population with Depressive DisordersWednesday, 15 May 2013SPP1.1Cheung HY Be a Happy Lady – How Urologists Help Thursday, 16 May 2013 MC1.2Cheung LYSDevelopment of a Regional Intensive Care Unit (ICU) Database forLongitud<strong>in</strong>al ICU Performance Monitor<strong>in</strong>g: Summary and the WayForwardWednesday, 15 May 2013SPP1.2Cheung NTHow Information Technology Has Improved Quality and Safety of Cl<strong>in</strong>icalServicesWednesday, 15 May 2013PS2.2Cheung SSNurse Initiated Sequential Compression Device Application <strong>Programme</strong>for Total Knee Replacement PatientWednesday, 15 May 2013SPP1.3Chiang CS Percutaneous Coronary Intervention – Past, Present and Future Thursday, 16 May 2013 MC2.1Chiang LKThe Outcomes of Ambulatory Electrocardiography (AECG or Holter)Performed for Patients with Symptoms Related to Cardiac Arrhythmia <strong>in</strong>the Primary Care: A Case Series ReportWednesday, 15 May 2013SPP1.4Choo KL,Hui E,Chan KS,Wong CP,Chan MHospital Authority City Forum – Next Step <strong>in</strong> Community Care Thursday, 16 May 2013 S3
26HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by First AuthorSessionsCSMCPPSCorporate Scholarship PresentationsMasterclassesPlenary SessionsParallel SessionsSSPPSTSymposiumsService Priorities and <strong>Programme</strong>sSpecial TopicsFirst Author Title Presentation Date SessionChow YF Procedural Sedation: Challenges and Opportunities Thursday, 16 May 2013 S1.3Chu KYChu WYAPharmacist Steps to Integrated Care <strong>in</strong> High-risk Geriatrics – Ward AgedPatient Pharmacist Service (WardAPPS)Overseas Corporate Scholarship <strong>Programme</strong> for Allied HealthProfessionals 2011 – Attachment <strong>Programme</strong> for Allied HealthProfessionals <strong>in</strong> Primary and Community Care of Patients Suffer<strong>in</strong>g fromChronic Lung DiseasesThursday, 16 May 2013Thursday, 16 May 2013SPP8.1CS2.3Chung J Shar<strong>in</strong>g of the Nurse Consultant Role <strong>in</strong> Emergency Care Service Wednesday, 15 May 2013 PS4.4Clay G Tra<strong>in</strong><strong>in</strong>g and Support<strong>in</strong>g Managers to Improve Staff Performance Wednesday, 15 May 2013 PS3.1Curran I Innovation <strong>in</strong> Healthcare Education – Tra<strong>in</strong><strong>in</strong>g for Professional Excellence Thursday, 16 May 2013 ST4.1Dickson GLead<strong>in</strong>g Change <strong>in</strong> Health Systems: The Y<strong>in</strong> and Yang of MedicalLeadershipWednesday, 15 May 2013ST2.1Easton J Sav<strong>in</strong>g Healthcare: Susta<strong>in</strong><strong>in</strong>g High Quality Healthcare Services Wednesday, 15 May 2013 P1.1Easton J Quality Healthcare: Cultural Change for Quality, Patient Safety and Value Thursday, 16 May 2013 S1.1Fitzpatrick J The Academic Perspective on Creat<strong>in</strong>g a Positive Practice Environment Thursday, 16 May 2013 MC3.2Fung H Healthcare Service Remodell<strong>in</strong>g: Hong Kong Experience Thursday, 16 May 2013 S10.3Fung S Build<strong>in</strong>g a Magnet Hospital – Local Perspective Thursday, 16 May 2013 MC3.3Fung SH Cardiopulmonary Bypass – an Evidence-based Change of Practice Wednesday, 15 May 2013 SPP4.3Fung SL Procedural Sedation for Flexible Bronchoscopy <strong>in</strong> Grantham Hospital Thursday, 16 May 2013 SPP5.3Goldsman AResources Plann<strong>in</strong>g for Healthcare – Operational Delivery Networks <strong>in</strong>LondonWednesday, 15 May 2013 P4.2Goldsman A Coord<strong>in</strong>ate My Care (CMC) Thursday, 16 May 2013 S10.1Haxby E Patient Safety and Human Factors Wednesday, 15 May 2013 P1.2Haxby E Cl<strong>in</strong>ical Risk Management Thursday, 16 May 2013 S1.2Ho HSPromot<strong>in</strong>g Evidence-based Practice <strong>in</strong> Prevent<strong>in</strong>g Methicill<strong>in</strong>-resistantStaphylococcus Aureus (MRSA) Bacteremia <strong>in</strong> Patients Hav<strong>in</strong>g CentralVenous Catheter Undergo<strong>in</strong>g HaemodialysisThursday, 16 May 2013SPP5.1Ho LFSTAR Project: Strategic Targets Aim to Reduce Haemodialysis CatheterrelatedBloodstream InfectionThursday, 16 May 2013SPP5.2Ho OMExperience of Us<strong>in</strong>g Hydrogen Peroxide Vaporisation for Prevent<strong>in</strong>gEnvironmental Transmission of the Multi-drug Resistant Organism –Vancomyc<strong>in</strong>-Resistant EnterococciThursday, 16 May 2013SPP7.1Ho SSNew Paradigm <strong>in</strong> Manag<strong>in</strong>g Patients with Chronic Illness through PatientEngagementWednesday, 15 May 2013SPP3.5Ho SYSRoles and Challenges of Diagnostic Radiographer Consultant <strong>in</strong> HongKongWednesday, 15 May 2013PS5.1Hung CT Impact of Hospital Accreditation on Public Hospitals Thursday, 16 May 2013 S11.2J<strong>in</strong> ECThe Position<strong>in</strong>g and Development of Integrated Traditional Ch<strong>in</strong>ese andWestern Medic<strong>in</strong>e Hospitals <strong>in</strong> Ma<strong>in</strong>land Ch<strong>in</strong>aWednesday, 15 May 2013ST1.2Koo WMJThe Road Ahead for Hospital Authority Transplant Coord<strong>in</strong>ation Service:Silver AnniversaryWednesday, 15 May 2013PS2.3Kwan CK Cancer Biology: Predictive Biomarkers for Tailored Therapies Thursday, 16 May 2013 CS1.1Kwan WMMFirst Year of 24/7 Acute Stroke Unit (ASU) and Stroke ThrombolyticServiceThursday, 16 May 2013SPP7.5Kwong SFS Musculoskeletal Physiotherapy Service Wednesday, 15 May 2013 PS5.3Lam BHSAchiev<strong>in</strong>g Susta<strong>in</strong>able and Significant Reduction <strong>in</strong> Methicill<strong>in</strong>-resistantStaphylococcus Aureus (MRSA) Bacteremia Rates Over Five Years <strong>in</strong> aMajor Acute General Hospital: A Multi-level Strategic ApproachWednesday, 15 May 2013SPP2.1
SessionsCSMCPPSCorporate Scholarship PresentationsMasterclassesPlenary SessionsParallel SessionsSSPPSTSymposiumsService Priorities and <strong>Programme</strong>sSpecial TopicsFirst Author Title Presentation Date SessionLam KKAThe Patient Engagement <strong>Programme</strong> <strong>in</strong> Hong Kong – The Leg Club(Review and Forward)<strong>Programme</strong> by First AuthorThursday, 16 May 2013SPP7.2Lam LCC Advance Measures <strong>in</strong> Promot<strong>in</strong>g Radiation Safety for Operat<strong>in</strong>g Theatre Thursday, 16 May 2013 SPP6.4Lam WK Motivat<strong>in</strong>g Staff for Performance Wednesday, 15 May 2013 PS3.2Lau C Patients' Rights and Professional Dignity Thursday, 16 May 2013 ST3.227HOSPITAL AUTHORITY CONVENTION 2013Lau COverseas Paediatric Cl<strong>in</strong>ical Pharmacy Tra<strong>in</strong><strong>in</strong>g and Setup of PaediatricSatellite Pharmacy <strong>in</strong> Pr<strong>in</strong>cess Margaret HospitalThursday, 16 May 2013CS2.4Lau CS Credential<strong>in</strong>g: Perspectives from the Academy Thursday, 16 May 2013 S6.1Lau STMulti-discipl<strong>in</strong>ary Supported Discharge <strong>Programme</strong> for Stroke Patients <strong>in</strong>Our Lady of Maryknoll Hospital (OLMH)Wednesday, 15 May 2013SPP3.7Law TCEffectiveness of the Trivalent Seasonal Influenza Vacc<strong>in</strong>e of Hong KongInstitutionalised Elderly: A 12-month Retrospective Cohort StudyWednesday, 15 May 2013SPP3.4Lee A Hospital Accreditation: A Private Hospital’s Experience Thursday, 16 May 2013 S11.1Lee BThe Journey of Change for Non-emergency Ambulance Transfer Service(NEATS): From an Ombudsman Case to a Modernised ServiceWednesday, 15 May 2013PS2.1Lee KCEffectiveness of Barcode Track<strong>in</strong>g <strong>in</strong> Document<strong>in</strong>g and Prevent<strong>in</strong>g PatientSpecimen Identification Errors <strong>in</strong> Anatomical Pathology LaboratoryThursday, 16 May 2013SPP5.5Lee KYMTranscatheter Aortic Valve Implantation (TAVI) Queen Elizabeth HospitalRegistry – A Multi-discipl<strong>in</strong>ary Team ApproachThursday, 16 May 2013SPP7.3Lee LYJ New Roles of Occupational Therapist <strong>in</strong> Mental Health Service –Enhanc<strong>in</strong>g Access to Psychological Interventions for People withCommon Mental DisordersWednesday, 15 May 2013PS5.2Lee SY,Tang SKOverseas Corporate Scholarship <strong>Programme</strong> 2011/12 at Children’sHospital of Philadelphia (CHOP): Post Tra<strong>in</strong><strong>in</strong>g Shar<strong>in</strong>gThursday, 16 May 2013CS2.2Lee WK The Roles and Challenges of Wound Nurse Consultant <strong>in</strong> Hong Kong Wednesday, 15 May 2013 PS4.3Leung G Tackl<strong>in</strong>g Complex Chronic Conditions – Apply What We Already Know Thursday, 16 May 2013 S5.2Leung HBCan Coat<strong>in</strong>g the Ward Environment with Visible Light ActivatedPhotocatalyst Reduce the Hospital Acquired Infection Rate?Thursday, 16 May 2013SPP7.4Leung KLAEarly Steps along Credential<strong>in</strong>g <strong>in</strong> Hong Kong – Experience of a Collegeand Private Hospital OrganiserThursday, 16 May 2013 S6.2Leung SKProtocol Driven Assessment <strong>Programme</strong> Effectively Shortens New CaseWait<strong>in</strong>g TimeWednesday, 15 May 2013SPP4.6Leung SYInnovative Lymphedema Management <strong>Programme</strong> (LMP) <strong>in</strong> Tung WahHospital (TWH) for Breast Cancer Patients to Improve Service Efficiencyand EffectivenessWednesday, 15 May 2013SPP4.5Li CKImprovement of Cure Rate <strong>in</strong> Childhood Acute Lymphoblastic Leukaemia:No New Drugs <strong>in</strong> the Past Three DecadesThursday, 16 May 2013MC2.3Li KKThe Effect of Introduc<strong>in</strong>g Rout<strong>in</strong>e Use of Intracameral Cefuroximeon Post-operative Endophthalmitis <strong>in</strong> Cataract Surgery <strong>in</strong> a Ch<strong>in</strong>esePopulationThursday, 16 May 2013SPP5.6L<strong>in</strong>g WMAdvanced Oncology Nurs<strong>in</strong>g Practice <strong>in</strong> Intravenous Bolus Injection ofCytotoxic Vesicants: Our 14-year ExperienceThursday, 16 May 2013SPP6.5Liu SYEnhancement <strong>Programme</strong> on Quality Care Integrated with Life EducationWorkshop for Healthcare Assistants (HCAs)Wednesday, 15 May 2013SPP2.2Lo CCKSimulation Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Hospital Authority Central Intern Orientation<strong>Programme</strong> to Promote Patient Safety <strong>in</strong> Daily Hospital PracticeThursday, 16 May 2013SPP6.6Lo KYEvaluation of Sk<strong>in</strong>-to-sk<strong>in</strong> Contact <strong>in</strong> Neonatal Ward from Parents’ andNurses’ PerspectivesThursday, 16 May 2013SPP8.2Lo SV Challenges Ahead <strong>in</strong> Healthcare Management Thursday, 16 May 2013 S5.3Mackway-Jones KStructur<strong>in</strong>g the Medical Response to Major Incidents: The Power ofMajor Incident Medical Management and Support (MIMMS)Wednesday, 15 May 2013 P5.2
28HOSPITAL AUTHORITY CONVENTION 2013<strong>Programme</strong> by First AuthorSessionsCSMCPPSCorporate Scholarship PresentationsMasterclassesPlenary SessionsParallel SessionsSSPPSTSymposiumsService Priorities and <strong>Programme</strong>sSpecial TopicsFirst Author Title Presentation Date SessionMak SSCross-Clusters Collaborative <strong>Programme</strong> to Better Oncology CareDelivery ModelThursday, 16 May 2013Mak T Outbreaks of Hypoglycaemia Thursday, 16 May 2013 MC4.1Mak YFImpact on Further Utilisation of Hospital Services Among DischargedFrail Elders – an Evaluation of Integrated Care and Discharge SupportService <strong>in</strong> Kowloon Central ClusterWednesday, 15 May 2013CS1.2SPP1.5Mok YT,Lee WWSee What Are Beh<strong>in</strong>d (SWAB): Four Factors Lead<strong>in</strong>g to SuccessfulChanges <strong>in</strong> Swab Count<strong>in</strong>g Practice <strong>in</strong> Pr<strong>in</strong>ce of Wales HospitalThursday, 16 May 2013SPP7.6Mui JMulti-discipl<strong>in</strong>ary Case Management Model for People with SevereMental IllnessWednesday, 15 May 2013PS4.1Mulley AG Delivery Science and the Future of Healthcare Leadership Wednesday, 15 May 2013 ST2.2Mulley AG Shared Decision Mak<strong>in</strong>g – Why Patients’ Preferences Matter Thursday, 16 May 2013 ST3.1Ng CKMulti-discipl<strong>in</strong>ary Home Mechanical Ventilation (HMV) <strong>Programme</strong> forPatients with Neuromuscular Diseases (NMD) <strong>in</strong> Queen Elizabeth Hospital(QEH)Wednesday, 15 May 2013SPP2.3Ng JPost Tra<strong>in</strong><strong>in</strong>g Shar<strong>in</strong>g on Hands on Cl<strong>in</strong>ical Experience of PaediatricAnaesthesia <strong>in</strong> the Children’s Hospital at Westmead (CHW)Thursday, 16 May 2013CS2.1Ng JSCDy<strong>in</strong>g at Home – A Cross-specialty Multi-discipl<strong>in</strong>ary Effort to Fulfill theLast Wish of Term<strong>in</strong>ally Ill PatientsThursday, 16 May 2013SPP7.7Ng LCollaborative Multi-discipl<strong>in</strong>ary Approach to Enhance Quality Care forChronic Obstructive Pulmonary Disease (COPD) Patients <strong>in</strong> Primary CareWednesday, 15 May 2013SPP2.4Ng MP Report of Pilot Empowerment <strong>Programme</strong> for Pakistani Diabetics Wednesday, 15 May 2013 SPP3.6Ng WYGMulti-modal Strategy for Improv<strong>in</strong>g Hand Hygiene Compliance InIntensive Care UnitWednesday, 15 May 2013SPP1.6Ng YHGMeet<strong>in</strong>g Needs, Fill<strong>in</strong>g Gaps: An Integration of a Written Pamphlet and aMultimedia Orientation <strong>Programme</strong> to Patients to Promote Cont<strong>in</strong>uousQuality Improvement <strong>in</strong> Surgical WardThursday, 16 May 2013SPP8.3Ong CYTOptimis<strong>in</strong>g Patient Flow as a Way of Improv<strong>in</strong>g Health Service <strong>in</strong> a LowRisk Obstetric Cl<strong>in</strong>icWednesday, 15 May 2013SPP1.7Porter CBuild<strong>in</strong>g a Magnet Nurs<strong>in</strong>g Department: The Mount S<strong>in</strong>ai Medical CentreExperienceThursday, 16 May 2013MC3.1RussellweiszDJRussellweiszDJPublic-Private Collaboration: A Successful Case <strong>in</strong> Australia Wednesday, 15 May 2013 P2.2The Australian Experience: The Public-Private Partnership (PPP) Thursday, 16 May 2013 S7.2She HFAPositive Outcome from Implementation of Patient Safety Round byFrontl<strong>in</strong>e Staff <strong>in</strong> Surgical DepartmentThursday, 16 May 2013SPP5.7Shiu CKSA Life Review Project for Term<strong>in</strong>ally Ill Palliative Care Patients Under Careof Cl<strong>in</strong>ical Oncology DepartmentWednesday, 15 May 2013SPP2.5Shortell SUSA Healthcare Reform: Early Lessons from Accountable CareOrganisationsWednesday, 15 May 2013 P3.1Shortell S The Role of Value-based Purchas<strong>in</strong>g <strong>in</strong> United States Healthcare Reform Thursday, 16 May 2013 S9.1Shum KL Disaster Response – from Scene to Hospital Wednesday, 15 May 2013 PS1.1S<strong>in</strong> YC Retention of Support<strong>in</strong>g Staff Start<strong>in</strong>g from Their Pre-employment Thursday, 16 May 2013 SPP6.3Stripp A Ambulatory Care Model Wednesday, 15 May 2013 P4.1Stripp A Ambulatory Care: A Management Initiative or a Cl<strong>in</strong>ical Need? Thursday, 16 May 2013 S10.2Tam KFMulti-discipl<strong>in</strong>ary Input for Discharge Management <strong>in</strong> Hong KongBuddhist Hospital (HKBH)Wednesday, 15 May 2013SPP2.6Tam WS Medical Records Retrieval <strong>in</strong> Ophthalmology Cl<strong>in</strong>ic (EYE OPD) Thursday, 16 May 2013 SPP6.7Tang CNApplication of Simulators to Enhance the Tra<strong>in</strong><strong>in</strong>g of M<strong>in</strong>imal AccessSurgeryThursday, 16 May 2013ST4.2
SessionsCSMCPPSCorporate Scholarship PresentationsMasterclassesPlenary SessionsParallel SessionsSSPPSTSymposiumsService Priorities and <strong>Programme</strong>sSpecial TopicsFirst Author Title Presentation Date SessionTong WTsang KP,Leung KP,Yip SWL,Dai D,Siu YLS,Wong YLDiagnostic Strategy and Laboratory Preparedness <strong>in</strong> the Face ofEmerg<strong>in</strong>g Diseases<strong>Programme</strong> by First AuthorWednesday, 15 May 2013 P5.1Hospital Authority City Forum – Partner<strong>in</strong>g with Patients Thursday, 16 May 2013 S229HOSPITAL AUTHORITY CONVENTION 2013Tse KSNew Radiation-free Era <strong>in</strong> Reflux Imag<strong>in</strong>g for Paediatric Ur<strong>in</strong>ary TractInfection (UTI): Void<strong>in</strong>g Urosonography with Intravesical UltrasoundContrast – First Local Pilot StudyThursday, 16 May 2013SPP8.4Tse MLToxico<strong>in</strong>telligence – Prepar<strong>in</strong>g for the Expected and UnexpectedPoison<strong>in</strong>gsThursday, 16 May 2013MC4.3Tse NEvolution of Resource Allocation <strong>in</strong> Hospital Authority and the ValuesCreatedThursday, 16 May 2013 S9.2Tsui PTTen-po<strong>in</strong>t System of Pr<strong>in</strong>cess Margaret Hospital Cardiac InterventionCentreWednesday, 15 May 2013SPP4.7Wong AYH Use of Water Swallow<strong>in</strong>g Test as a Screen<strong>in</strong>g Tool <strong>in</strong> Acute Stroke Unit Thursday, 16 May 2013 SPP8.6Wong DIntroduc<strong>in</strong>g High Volume Cataract Surgery <strong>in</strong> Hong Kong: Improv<strong>in</strong>gSurgeon Efficiency Without Sacrific<strong>in</strong>g Patient SafetyThursday, 16 May 2013 S4.1Wong KLAEnhancement <strong>in</strong> Radiotherapy Treatment for Breast Cancer Patients:From One-by-one to Cont<strong>in</strong>uousWednesday, 15 May 2013SPP4.4Wong MSJOverseas Corporate Scholarship <strong>Programme</strong> (OCSP) for Physiotherapist<strong>in</strong> Musculoskeletal Specialty <strong>in</strong> 2011Thursday, 16 May 2013CS1.3Wong PSF Less is More: A Simple Chest Dra<strong>in</strong> Site Dress<strong>in</strong>g is Good Enough Thursday, 16 May 2013 SPP8.5Wong SMR Ongo<strong>in</strong>g Poison<strong>in</strong>g Issues <strong>in</strong> Hong Kong Thursday, 16 May 2013 MC4.2Wong YFInnovative Approach of Enhanc<strong>in</strong>g Patient Education Us<strong>in</strong>g “DiabetesConversation Map” to Improve Outcome and Insul<strong>in</strong> Commencement <strong>in</strong>General Outpatient Cl<strong>in</strong>ic (GOPC), Hong Kong East ClusterWednesday, 15 May 2013SPP3.3Yao R Paediatric Satellite Pharmacy <strong>in</strong> Pr<strong>in</strong>cess Margaret Hospital Thursday, 16 May 2013 SPP5.4Yau S Partnership for Mental Health Thursday, 16 May 2013 S12.1Yeung D Use of Casemix <strong>in</strong> Cl<strong>in</strong>ical Outcome Management Thursday, 16 May 2013 S8.2Yeung KCAConsultant Physiotherapist <strong>in</strong> Musculoskeletal: Experience Shar<strong>in</strong>g fromPr<strong>in</strong>ce of Wales HospitalWednesday, 15 May 2013PS5.4Yip EYTEvaluation of the Oncology Pharmacists’ Therapeutic Recommendations<strong>in</strong> the Oncology Wards and Cl<strong>in</strong>ics at Pr<strong>in</strong>cess Margaret HospitalWednesday, 15 May 2013SPP2.7Yip YTE Provision of Oncology Pharmacy Service at Pr<strong>in</strong>cess Margaret Hospital Thursday, 16 May 2013 CS1.4Yiu KC How Can Watch-PAT Adopt the “WIN” Strategy Thursday, 16 May 2013 SPP8.7Yiu TLIPartnership for Community Wellness – Experience Shar<strong>in</strong>g <strong>in</strong>Collaboration between the Medical and Social Welfare SectorThursday, 16 May 2013 S12.3Yuen WCAApply<strong>in</strong>g Variable Life Adjusted Display (VLAD) <strong>in</strong> Monitor<strong>in</strong>g SurgicalOperation PerformanceThursday, 16 May 2013MC1.1Zhang ZJ Hospital Accreditation <strong>in</strong> Ma<strong>in</strong>land Ch<strong>in</strong>a Wednesday, 15 May 2013 ST1.1
30HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsRoom S224 & S225SPP1Enhanc<strong>in</strong>g Healthcare DeliverySPP2Consolidat<strong>in</strong>g Service ProvidersSPP3Consolidat<strong>in</strong>g Service ReceiversSPP4Quality and Safety <strong>in</strong> Healthcare IRoom S226 & S227SPP5Quality and Safety <strong>in</strong> Healthcare IISPP6Susta<strong>in</strong>able WorkforceSPP7Modernisation of HealthcareSPP8Young HA Investigators Presentations
Speed PresentationsService Priorities and <strong>Programme</strong>sWednesday, 15 May 2013 10:15–10:45 Room 224–225Location Presentation Name Post Institution Topic of PresentationASPP-P1.6SPP-P1.8SPP-P1.9Dr CHANLaamMs TANGMan-neiDr CHANW<strong>in</strong>g-lokAssociateConsultantRegisteredNurseResidentDepartment of FamilyMedic<strong>in</strong>e and PrimaryHealth Care, NewTerritories West ClusterDepartment of Medic<strong>in</strong>e,North District HosptialDepartment of Cl<strong>in</strong>icalOncology, Queen MaryHospitalA Seven Years Review on Diabetes Mellitus(DM) Service <strong>in</strong> General Outpatient Cl<strong>in</strong>ics: TheImpact and Way ForwardRole Expansion of Nurses: Nurse-driveEchocardiographic Exam<strong>in</strong>ationEnhanc<strong>in</strong>g Patient Comfort Dur<strong>in</strong>g Post-Radiotherapy Endoscopic Assessmentsof Nasopharynx by Reduc<strong>in</strong>g Number ofUnnecessary Biopsies After Review of OneyearResults31HOSPITAL AUTHORITY CONVENTION 2013SPP-P1.10Dr CHENGCheuk-hongResidentDepartment of FamilyMedic<strong>in</strong>e, Pr<strong>in</strong>ce of WalesHospitalAudit on Management of Patients with Asthma<strong>in</strong> Fanl<strong>in</strong>g Family Medic<strong>in</strong>e Cl<strong>in</strong>icSPP-P1.11Dr KLCHEUNGAssociateConsultantDepartment of FamilyMedic<strong>in</strong>e and PrimaryHealth Care, KowloonWest ClusterChanges of East Kowloon General OutpatientCl<strong>in</strong>ic — Towards Multi-discipl<strong>in</strong>ary Team andCollaboration with Community PartnersSPP-P3.29Ms MAKPo-kitNurseConsultantNurs<strong>in</strong>g Services Division,Ruttonjee and Tang ShiuK<strong>in</strong> HospitalFrom Do-not-resuscitation Order to End-of-Life Care for the Elders <strong>in</strong> the Departmentof Geriatrics, Ruttonjee and Tang Shiu K<strong>in</strong>HospitalsSPP-P3.33Ms TO Oik<strong>in</strong>gAdvancedPracticeNurseCommunity Nurs<strong>in</strong>gService, Kwong WahHospitalHospital-community Partnership <strong>Programme</strong>for Patients with StomaBSPP-P3.34Ms TONGMei-hoiAdvancedPracticeNurseCommunity OutreachService Team, NorthDistrict HospitalImplementation of an Innovative “Puff VisualChart” to Enhance Puff Compliance of ChronicObstructive Pulmonary Disease (COPD)Patients <strong>in</strong> the CommunitySPP-P3.36Prof WONGElizaProfessorDivision of Health System,Policy and Management,The Jockey Club Schoolof Public Health andPrimary Care, The Ch<strong>in</strong>eseUniversity of Hong KongWhat are the Possible Determ<strong>in</strong>ants ofInpatient Satisfaction and Experience <strong>in</strong> PublicHospital Care Sett<strong>in</strong>g?SPP-P3.37Ms WONGMan-shuMabelRegisteredNurseNeonatal Intensive CareUnit, Queen ElizabethHospitalEvaluation of a Family-centred Intervention <strong>in</strong>a Special Care Baby Unit: Parental Outcomesand Nurs<strong>in</strong>g Staff Feedback on Kangaroo Care
32HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sSpeed PresentationsWednesday, 15 May 2013 10:15–10:45 Room 226–227Location Presentation Name Post Institution Topic of PresentationCSPP-P4.3SPP-P4.6SPP-P4.8Mr FUBenedictMs CHENGLai-p<strong>in</strong>gMr HO ChiwaiSeniorHospitalManagerAdvancedPracticeNurseNurseConsultantAdm<strong>in</strong>istrative ServicesDepartment, Pok Oi HospitalDepartment of Medic<strong>in</strong>e andRehabilitation, Tung WahEastern HospitalDepartment of Surgery,Pamela Youde NethersoleEastern HospitalImprov<strong>in</strong>g Patients’ Privacy/Dignity andSafety Dur<strong>in</strong>g Non-emergency AmbulanceTransfer Service (NEATS) Discharge bySett<strong>in</strong>g Up of NEATS Patients Wait<strong>in</strong>gLoungeCl<strong>in</strong>ical Enhancement for QualityImprovement <strong>Programme</strong>Quality and Safety <strong>in</strong> Tubes Management —the “See-through” Film Dress<strong>in</strong>g on BiliaryTubesSPP-P4.10Mr HUANGWen-haiKev<strong>in</strong>HospitalAdm<strong>in</strong>istratorIIPlann<strong>in</strong>g and Commission<strong>in</strong>g,Adm<strong>in</strong>istrative ServicesDepartment, Hong Kong WestClusterEnhance Schedul<strong>in</strong>g of Phlebotomy Services<strong>in</strong> Tung Wah Hospital through Discrete EventSimulation Model<strong>in</strong>gSPP-P4.11Dr CHKWOKResidentSpecialistDepartment of Medic<strong>in</strong>e andGeriatrics, Pr<strong>in</strong>cess MargaretHospitalElectronic Chemotherapy ProtocolPrescription Reduces Medication Errors andConserves Time of PhysiciansSPP-P8.4Dr CHANY<strong>in</strong>-hangAssociateConsultantDepartment of FamilyMedic<strong>in</strong>e and Primary HealthCare, New Territories WestClusterIntegrated Mental Health <strong>Programme</strong> (IMHP),a Structured Primary Care Mental Health<strong>Programme</strong>, Experience <strong>in</strong> T<strong>in</strong> Shui WaiSPP-P8.8Ms KPCHENGAdvancedPracticeNurseQuality and Safety Division,United Christian HospitalWhatsApp Quality and Safety Related Alert:Stay Connected with InternsDSPP-P8.9Dr CHIANGChi-leungResidentSpecialistDepartment of Cl<strong>in</strong>icalOncology, Tuen Mun HospitalManage Patients with Malignant PleuralEffusion (MPE) Us<strong>in</strong>g Indwell<strong>in</strong>g PleuralCatheter (IPC) for Intermittent Dra<strong>in</strong>age atOutpatient Sett<strong>in</strong>g: A Safe and Cost EffectiveApproachSPP-P8.17Dr KAMM<strong>in</strong>g-hoResidentDepartment of Surgery,Queen Elizabeth HospitalOutcomes of Major Surgery <strong>in</strong> PatientsAbove 85 Years OldSPP-P8.18Dr LI Heungw<strong>in</strong>gAssociateConsultantDepartment of FamilyMedic<strong>in</strong>e, New TerritoriesEast ClusterBr<strong>in</strong>g<strong>in</strong>g Old to New and Improv<strong>in</strong>gPrimary Care Management: Primary CareMusculoskeletal (MSK) Cl<strong>in</strong>ics
Speed PresentationsService Priorities and <strong>Programme</strong>sWednesday, 15 May 2013 15:45–16:15 Room 224–225Location Presentation Name Post Institution Topic of PresentationASPP-P1.16 Dr HUI Elsie Chief of Service Medical and Geriatrics Unit,Shat<strong>in</strong> HospitalSPP-P1.21SPP-P1.23Mr LEE CheukkiuJohnsonDr DAI LokkwanDavidAssistant SocialWork OfficerConsultantMedical Social Services,Yan Chai HospitalCentral Committee forCompla<strong>in</strong>ts Managementand Patient Engagement,Hospital AuthorityA Geriatric Service for End-of-lifePatients Resid<strong>in</strong>g <strong>in</strong> Residential CareHomes Dur<strong>in</strong>g W<strong>in</strong>ter SurgePre-admission Discharge and CarePlann<strong>in</strong>g Model of Medical SocialServices for Total Jo<strong>in</strong>t ReplacementService of Yan Chai HospitalMediation Towards Positive PatientExperience33HOSPITAL AUTHORITY CONVENTION 2013SPP-P1.24Mr LEUNGKwok-kuenTerenceAdvancedPractice NurseDepartment of Surgery,North District HospitalNurse-led Rubber Band Ligation ofHaemorrhoids Shortens Patient'sWait<strong>in</strong>g Time of Procedure Arrangementand Follow-upSPP-P1.27Mr MAK Chu-faiTrevorPharmacistDepartment of Pharmacy,Pamela Youde NethersoleEastern HospitalImpact of Pharmacist-ledAnticoagulation Cl<strong>in</strong>ic at PamelaYoude Nethersole Eastern Hospital onPatients' Anticoagulation Control andCl<strong>in</strong>ical OutcomesSPP-P3.7 Dr CHAN May Pharmacist Department of Pharmacy,Tseung Kwan O HospitalA Pilot Study of Chronic ObstructivePulmonary Disease (COPD) Selfmanagement<strong>Programme</strong> at TseungKwan O HospitalSPP-P3.13Dr CHU M<strong>in</strong>gchiAssociateConsultantPa<strong>in</strong> ManagementCentre, Alice Ho Miu L<strong>in</strong>gNethersole HospitalImproved Work Rate and ReducedMedical Utilisation with Integrated Pa<strong>in</strong>Management <strong>Programme</strong>BSPP-P3.18 Miss LAI Eva Pharmacist Ngau Tau Kok GeneralOutpatient Cl<strong>in</strong>icA Randomised Controlled Study on theEffect of Counsel<strong>in</strong>g Session Providedby Pharmacist on Metered-dose Inhaler(MDI) Technique Among Patients <strong>in</strong>General Outpatient Cl<strong>in</strong>icSPP-P3.21Dr FUNG Ch<strong>in</strong>gmanJennyManagerNew Territories EastCommunity RehabilitationDay Center, SAHK( 香 港 耀 能 協 會 )Cont<strong>in</strong>uum of Care for OrthopedicPatient — from Hospital to Communitythrough Cl<strong>in</strong>ical PathwaySPP-P8.21Dr LAI Suk-yiIreneAssociateConsultantDepartment of FamilyMedic<strong>in</strong>e and PrimaryHealth Care, Hong KongEast ClusterThe Effectiveness of Comb<strong>in</strong>edNicot<strong>in</strong>e Replacement Therapy forSmok<strong>in</strong>g Cessation
34HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sSpeed PresentationsWednesday, 15 May 2013 15:45–16:15 Room 226–227Location Presentation Name Post Institution Topic of PresentationSPP-P7.3SPP-P7.4Dr CHAN Tsz-mimJasm<strong>in</strong>eMr CHEE SweehawBryanAssociateConsultantPhysiotherapist IIPalliative CareUnit, Departmentof Medic<strong>in</strong>e andGeriatrics, OurLady of MaryknollHospitalPhysiotherapyDepartment, QueenElizabeth HospitalCare of the Dy<strong>in</strong>g: End-of-life CarePathway <strong>in</strong> Palliative Care UnitEffects of Robot-assisted Arm Tra<strong>in</strong><strong>in</strong>gfor Promot<strong>in</strong>g Motor Recovery <strong>in</strong>Patients After StrokeCSPP-P7.5Dr CHEUNG Waiy<strong>in</strong>Resident SpecialistPalliative Care Team,United ChristianHospitalEarly Experiences at United ChristianHospital <strong>in</strong> Advance Directives Refus<strong>in</strong>gCardiopulmonary ResuscitationSPP-P7.6 Dr CHOW Yat AssociateConsultantPsychiatryDepartment, KwaiChung HospitalA Community Mental Health Call Centreto Strengthen Support to PsychiatricPatients and Caregivers <strong>in</strong> theCommunitySPP-P7.10Dr WONGEdmondAssociateConsultantDepartment ofMedic<strong>in</strong>e andGeriatrics, Pok OiHospitalConventional Coronary Angiogram vsHybrid Rotational Coronary AngiogramSPP-P8.26Mr LEE y<strong>in</strong>-takKenPhysiotherapist IDepartment ofPhysiotherapy, TuenMun HospitalSitt<strong>in</strong>g Tai Chi: A Novel Evidence-basedExercise Regime for Frail ElderlySPP-P8.27 Ms LO Ela<strong>in</strong>e Pharmacist Department ofPharmacy, KwongWah HospitalEffective Utilisation of Resourcesthrough Identification of High RiskPatient Groups <strong>in</strong> Pharmacist-runMedication Reconciliation ServiceDSPP-P8.32 Dr TSE Hoi-nam Resident Specialist Medic<strong>in</strong>e andGeriatricsDepartment, KwongWah HospitalHigh-Dose N-Acetylcyste<strong>in</strong>e <strong>in</strong> StableChronic Obstructive Pulmonary Disease(COPD): The One-year, Double-bl<strong>in</strong>d,Randomised, Placebo-controlledHealth Inequalities and Age<strong>in</strong>g <strong>in</strong> theCommunity Evaluation (HIACE) StudySPP-P8.35 Mr WONG Errol Pharmacist Department ofPharmacy, CaritasMedical CentreSPP-P8.36 Mr WONG Ka-hei Physiotherapist II PhysiotherapyDepartment, TuenMun HospitalRenal Dosage Adjustment for Patientson Antimicrobials with an Automated<strong>Programme</strong>: A Pilot StudyTranscranial Direct Current Stimulation:A Novel Technology for Upper LimbRehabilitation <strong>in</strong> Stroke Patients — aPilot <strong>Programme</strong>
Speed PresentationsService Priorities and <strong>Programme</strong>sThursday, 16 May 2013 10:15–10:45 Room 224–225Location Presentation Name Post Institution Topic of PresentationASPP-P1.32SPP-P1.33SPP-P1.35Mr WONG Fu-yanThomasDr WONG KamcheungMr TANG H<strong>in</strong>gwanStephenPhysiotherapist ISenior Medical OfficerNurs<strong>in</strong>g OfficerPhysiotherapyDepartment,Kowloon HospitalDepartment ofTuberculosis andChest, Wong TaiS<strong>in</strong> HospitalIntensive CareUnit, Alice Ho MiuL<strong>in</strong>g NethersoleHospitalSPP-P6.12 Dr HUI Aric-josun Associate Consultant Departmentof Medic<strong>in</strong>e,Alice Ho MiuL<strong>in</strong>g NethersoleHospitalEffectiveness of Hydrotherapy<strong>Programme</strong> for Patient with SevereOsteoarthritis KneeWritten Action Plan and TelephoneHotl<strong>in</strong>e Support to Reduce HospitalReadmission <strong>in</strong> Patients with ChronicObstructive Pulmonary DiseaseCl<strong>in</strong>ical Competence EnhancementTra<strong>in</strong><strong>in</strong>g <strong>Programme</strong> on IntegratedVentilator Wean<strong>in</strong>g <strong>Programme</strong>Comparison of ColonoscopicPerformance Between Medical andNurse Endoscopists: A RandomisedControlled Study <strong>in</strong> Asia35HOSPITAL AUTHORITY CONVENTION 2013SPP-P6.28 Dr PON Wai-pi Resident Department ofFamily Medic<strong>in</strong>eand PrimaryHealthcare,Caritas MedicalCentrePrevalence and Associated Factorsof Burnout Among Doctors Work<strong>in</strong>g<strong>in</strong> Public General Outpatient Cl<strong>in</strong>ic(GOPC) <strong>in</strong> Kowloon West Cluster ofHong KongSPP-P4.13Mr LAM WaichuenRegistered NurseInfection ControlTeam, PamelaYoude NethersoleEastern HospitalEffects of Antibiotic Stewardship<strong>Programme</strong> to Reduce Use ofIntravenous (IV) Qu<strong>in</strong>oloneSPP-P4.18 Ms SH LEE Advanced PracticeNurseDivision ofNephrology,Departmentof Medic<strong>in</strong>eand Geriatrics,Pr<strong>in</strong>cessMargaret HospitalThe Vascular Care Re-eng<strong>in</strong>eer<strong>in</strong>g(VCR) Initiative: The impact of VCR<strong>Programme</strong> on Outcomes of NewlyCreated Vascular AccessBSPP-P4.22Ms LEUNG YungaiAdvanced PracticeNurseDepartment ofObstetrics andGynaecology,Kwong WahHospitalThe Effect of Early Sk<strong>in</strong>-to-sk<strong>in</strong>Contact on Exclusive Breastfeed<strong>in</strong>gRate and Self-efficacy of Breastfeed<strong>in</strong>gAmong Hong Kong Ch<strong>in</strong>ese WomenSPP-P4.24 Ms LI Shu-fan Ward Manager MedicalDepartment, TungWah HospitalSPP-P4.31 Mr MAN Ho-y<strong>in</strong> Senior Nurs<strong>in</strong>g Officer North LantauHospitalCommission<strong>in</strong>gOffice, Pr<strong>in</strong>cessMargaret HospitalImprovement of Neurodiagnostic TestBook<strong>in</strong>g <strong>in</strong> Tung Wah HospitalNew Concept of Ward Design <strong>in</strong> NorthLantau Hospital — Decentralisation
36HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sSpeed PresentationsThursday, 16 May 2013 10:15–10:45 Room 226–227Location Presentation Name Post Institution Topic of PresentationCSPP-P5.3Ms CHAN NarchiNeritaSeniorPhysiotherapistSPP-P5.4 Miss WS CHAN AdvancedPractice NurseSPP-P5.6Mr CHAU KawaiDanielPhysiotherapist IDepartment ofPhysiotherapy, TuenMun HospitalInfection ControlTeam, Departmentof Pathology, TseungKwan O HospitalPhysiotherapyDepartment, QueenElizabeth HospitalLower Limbs Cast<strong>in</strong>g <strong>in</strong> Adjunct to Botul<strong>in</strong>iumTox<strong>in</strong> (BTX) Injection to Improve the GaitPattern for Patient with StrokeSharps Injury Reduction through Educationand Awareness <strong>Programme</strong>The Effectiveness of PhysiotherapyIntervention for Patients with Park<strong>in</strong>son'sDiseaseSPP-P5.9Ms CHUNGW<strong>in</strong>g-yanAdvancedPractice NurseDepartment of Surgery,Pr<strong>in</strong>ce of WalesHospitalSafe Use of Medical Equipment: To EnsureGood Quality Service <strong>in</strong> Cl<strong>in</strong>ical WorkplaceSPP-P4.23Dr LEUNG YukyanRockAssociateConsultantDepartment ofPathology and Cl<strong>in</strong>icalBiochemistry, QueenMary HospitalMore than a Ratio: A Review of TraumaTransfusion Protocol (TTP) <strong>in</strong> Queen MaryHospitalSPP-P7.11Mr LAM Was<strong>in</strong>gRegisteredNurseGeriatrics Unit,Department ofMedic<strong>in</strong>e andGeriatrics, UnitedChristian Hospital1+1=30 Half Hourly Ward Round at NightSPP-P7.13Dr LAU Mo-yeePollyCluster ManagerPhysiotherapyDepartment, QueenElizabeth HospitalEffectiveness of Underwater Gymnasium<strong>Programme</strong> for Patients with OsteoarthriticKnee ConditionDSPP-P7.15 Ms SP LEE ClusterDepartmentManagerDepartment ofDietetics, UnitedChristian HospitalMeasured Metabolic Requirement for SepticShock Patients Before and After Liberationfrom Mechanical VentilationSPP-P7.16Mr LEUNG ChikwongRegisteredNurseIntensive Care Unit,North District HospitalThe Implementation of Innovative Technology<strong>in</strong> Intensive Care Unit for Enhanc<strong>in</strong>gCommunication and Education with CriticallyIll Patient's Family MembersSPP-P7.19Dr LUI ChuntatAssociateConsultantDepartment ofAccident andEmergency, Tuen MunHospitalComputerisation of Frontl<strong>in</strong>e Physicians’Clerical Work, Medical Documentation andMedication Prescription Dur<strong>in</strong>g PatientAdmission — the eAdmit Project
Speed PresentationsService Priorities and <strong>Programme</strong>sThursday, 16 May 2013 15:45–16:15 Room 224–225Location Presentation Name Post Institution Topic of PresentationSPP-P2.1Dr CHAK WaikwongAssociateConsultantSPP-P2.4 Dr CHAN K<strong>in</strong>-wai AssociateConsultantDepartmentof Paediatricsand AdolescentMedic<strong>in</strong>e, TuenMun HospitalFamily Medic<strong>in</strong>eand Primary HealthCare Service,Kowloon WestClusterMulti-discipl<strong>in</strong>ary Management<strong>Programme</strong> of Paediatric RefractoryEpilepsy <strong>in</strong> New Territories WestCluster – a Holistic Longitud<strong>in</strong>al Carefrom Hospital to Community: A Cl<strong>in</strong>calAudit of Seizure, Cognitive and PsychobehaviouralOutcomeSignificant Reduction of SurgicalSpecialist Outpatient Wait<strong>in</strong>g Timethrough Collaboration Effort of FamilyMedic<strong>in</strong>e and Department of Surgery37HOSPITAL AUTHORITY CONVENTION 2013ASPP-P2.15 Dr LAM Bosco AssociateConsultantDepartmentof Pathology(Microbiology),Pr<strong>in</strong>cess MargaretHospitalTowards Zero Tolerance for CatheterrelatedBloodstream Infection: Comb<strong>in</strong><strong>in</strong>gHospital-wide and Targeted StrategiesSPP-P2.40Ms YUNG Waiy<strong>in</strong>gJanetAdvanced PracticeNurseDepartment of Ear,Nose and Throat,Pamela YoudeNethersole EasternHospitalAudit and Satisfaction Survey on EarSyr<strong>in</strong>g<strong>in</strong>g Service <strong>in</strong> Ear, Nose and ThroatSpecial Cl<strong>in</strong>ic – “Ear”SPP-P5.36Ms WAN Lai-yiSel<strong>in</strong>aSeniorOccupationalTherapistOccupationalTherapyDepartment,Kwong WahHospitalEffectiveness of Bowen TherapyPracticed by Occupational Therapist<strong>in</strong> Improv<strong>in</strong>g Physical Function andActivities of Daily Liv<strong>in</strong>g of People withShoulder Stiffness (Frozen Shoulder) –Interim ResultSPP-P4.32Mr MOK Ki-fungV<strong>in</strong>centAdvanced PracticeNurseQueen ElizabethHospital MedicalSpecialty VentilatorUnitThe Effectiveness of a NurseimplementedSedation Management onUnplanned ExtubationSPP-P4.34 Dr NG Lorna Senior MedicalOfficerFamily Medic<strong>in</strong>eand GeneralOutpatientDepartment,Kwong WahHospitalInnovations <strong>in</strong> Mobilis<strong>in</strong>g CommunityResources for Susta<strong>in</strong>able HypertensionCare <strong>in</strong> Primary Care Sett<strong>in</strong>gBSPP-P4.35Ms NG Sau-p<strong>in</strong>gMandyRegistered NurseInfection ControlTeam, Pr<strong>in</strong>cessMargaret HospitalThe Use of Tailor Design Strategy toPromote Influenza Immunisation RateAmong Healthcare Workers <strong>in</strong> Pr<strong>in</strong>cessMargaret HospitalSPP-P4.38 Dr TONG Macy AssociateConsultantDepartment ofOncology, Pr<strong>in</strong>cessMargaret HospitalSuccessful Reduction <strong>in</strong> the “Door-to-Needle Time” for Antibiotic Adm<strong>in</strong>istration<strong>in</strong> the Emergency Management ofChemotherapy-<strong>in</strong>duced NeutropenicFeverSPP-P4.40 Mr CHAN Denis Physiotherapist PhysiotherapyDepartment,Ruttonjee and TangShiu K<strong>in</strong> HospitalsHealthy Knee Voyage: ChronicDisease Management Model for KneeOsteoarthritis
38HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sSpeed PresentationsThursday, 16 May 2013 15:45–16:15 Room 226–227Location Presentation Name Post Institution Topic of PresentationCSPP-P5.19 Mr LAU Sai-kuk Registered Nurse Department ofMedic<strong>in</strong>e andGeriatrics, TuenMun HospitalSPP-P5.21 Dr LEE Ka-lok Resident Department ofImag<strong>in</strong>g andInterventionalRadiology, Pr<strong>in</strong>ceof Wales HospitalSPP-P5.28 Miss MA Yat-man Pharmacist Department ofPharmacy, PamelaYoude NethersoleEastern HospitalIntroduction of a Compact Alarm<strong>in</strong>gDevice to Safeguard TourniquetsReduction of Incorrect Identity IncidentDur<strong>in</strong>g Mobile Radiography by Us<strong>in</strong>gNew 2D Barcode System — Prelim<strong>in</strong>aryResultDesign and Implementation of OncologyPharmaceutical Care Service to EnhanceMedication Safety for Oncology PatientsSPP-P5.29 Ms NG Suk-ch<strong>in</strong>g Registered Nurse Depatment ofSurgery, QueenElizabeth HospitalEnhancement <strong>Programme</strong> on Preventionof Patient FallSPP-P5.35 Dr HO Yau-leung AssociateConsultantDepartment ofAnaesthesiaand IntensiveCare, Tuen MunHospitalPromotion of Pa<strong>in</strong> as Fifth Vital Sign andImplementation of Pa<strong>in</strong> ManagementProtocols Improve Post-operative Pa<strong>in</strong>Management <strong>in</strong> Tuen Mun HospitalSPP-P7.27 Mr SHUM Wai-ch<strong>in</strong>g Nurse Consultant Department ofMedic<strong>in</strong>e andTherapeutics,Pr<strong>in</strong>ce of WalesHospitalExpand<strong>in</strong>g Nurse's Roles and StrengthenCl<strong>in</strong>ical Collaboration to AccomplishCluster-based 24 hours ThrombolysisServices <strong>in</strong> New Territories East ClusterSPP-P7.30Mr TANG Tak-hungPeterPhysiotherapist IPhysiotherapyDepartment,Castle PeakHospitalAn Innovative Approach by Us<strong>in</strong>gAcupuncture for Improv<strong>in</strong>g the Ur<strong>in</strong>arySymptoms of Patients with Ketam<strong>in</strong>eDependenceDSPP-P7.34 Dr WONG K<strong>in</strong>g-y<strong>in</strong>g AssociateConsultantDepartment ofTuberculosis andChest, TWGHsWong Tai S<strong>in</strong>HospitalIntegrated Use of Virtual Bronchoscopyand Endobronchial Utlrasonography <strong>in</strong>Bronchoscopic Diagnosis of PeripheralLung LesionsSPP-P7.36 Mr WONG Sunny Advanced PracticeNurseNurs<strong>in</strong>g ServiceDivision, TseungKwan O HospitalImprovement Project of Wound CareNurs<strong>in</strong>g Service by Provision ofLymphoedema Management for Patientswith Related Lower Limb Ulcers (PilotScheme <strong>in</strong> Tseung Kwan O Hospital andCaritas Medical Centre)SPP-P7.40 Ms TH YIP Advanced PracticeNurseCommunityNurs<strong>in</strong>g Service,Pr<strong>in</strong>cess MargaretHospital“PEACE” <strong>Programme</strong>: To PromoteQuality of Dy<strong>in</strong>g for Frail Elders
Poster PresentationsSPP-P1 – Enhanc<strong>in</strong>g Healthcare DeliveryService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P1.1 Ms AU Kwai-kam Ward Manager Haematology Unit, Departmentof Medic<strong>in</strong>e and Geriatrics,Pr<strong>in</strong>cess Margaret HospitalSPP-P1.2 Ms AU Kwai-kam Ward Manager Haematology Unit, Departmentof Medic<strong>in</strong>e and Geriatrics,Pr<strong>in</strong>cess Margaret HospitalSPP-P1.3Dr CHAN TaileungDanielAssociateConsultantDepartment of CardiothoracicSurgery, Queen Mary HospitalImplementation of Autologous Peripheral Blood StemCell Transplantation Service at Pr<strong>in</strong>cess MargaretHospital: A Nurse-led Cl<strong>in</strong>ical ApproachEnhanc<strong>in</strong>g Service Efficiency — Reduc<strong>in</strong>g Wait<strong>in</strong>gTime for Type and Screen of Blood Products <strong>in</strong>Medical Day WardAdult Cardiac Surgery Audit <strong>in</strong> Queen Mary Hospital— the Dendrite Cl<strong>in</strong>ical System39HOSPITAL AUTHORITY CONVENTION 2013SPP-P1.4 Dr WAT Karen AssociateConsultantCl<strong>in</strong>ical Management Teams andCl<strong>in</strong>ical Services Department,Division One, Team Six, KwaiChung HospitalProspective Study on the Implication of thePsychogeriatric Outreach Service to the Private OldAge Home <strong>in</strong> a Local Region of Hong KongSPP-P1.5Ms CHAN KiuchorOccupationalTherapist IOccupational TherapyDepartment, Tai Po HospitalEarly Screen<strong>in</strong>g for Post-stroke Mild CognitiveImpairmentSPP-P1.6 Dr CHAN Laam AssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care, NewTerritories West ClusterA Seven Years Review on Diabetes Mellitus (DM)Service <strong>in</strong> General Outpatient Cl<strong>in</strong>ics: The Impact andWay ForwardSPP-P1.7Dr CHAN ManhungResidentDepartment of Family Medic<strong>in</strong>e,New Territories East ClusterBetter Promotion of Influenza Vacc<strong>in</strong>ation AmongPatients — Identify<strong>in</strong>g Determ<strong>in</strong>ants for InfluenzaVacc<strong>in</strong>ation for Adult Patients <strong>in</strong> Fanl<strong>in</strong>g FamilyMedic<strong>in</strong>e CentreSPP-P1.8Ms TANG ManneiRegisteredNurseDepartment of Medic<strong>in</strong>e, NorthDistrict HosptialRole Expansion of Nurses: Nurse-driveEchocardiographic Exam<strong>in</strong>ationSPP-P1.9Dr CHAN W<strong>in</strong>glokResidentDepartment of Cl<strong>in</strong>ical Oncology,Queen Mary HospitalEnhanc<strong>in</strong>g Patient Comfort Dur<strong>in</strong>g Post-RadiotherapyEndoscopic Assessments of Nasopharynx byReduc<strong>in</strong>g Number of Unnecessary Biopsies AfterReview of One-year ResultsSPP-P1.10Dr CHENGCheuk-hongResidentDepartment of Family Medic<strong>in</strong>e,Pr<strong>in</strong>ce of Wales HospitalAudit on Management of Patients with Asthma <strong>in</strong>Fanl<strong>in</strong>g Family Medic<strong>in</strong>e Cl<strong>in</strong>icSPP-P1.11 Dr KL CHEUNG AssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care,Kowloon West ClusterChanges of East Kowloon General Outpatient Cl<strong>in</strong>ic— Towards Multi-discipl<strong>in</strong>ary Team and Collaborationwith Community PartnersSPP-P1.12Ms CHU ShukwaiAdvancedPractice NurseAccident and EmergencyDepartment, Pamela YoudeNethersole Eastern HospitalEmergency Nurse Cl<strong>in</strong>ic <strong>in</strong> Hong Kong East Cluster: AOne-year ReviewSPP-P1.13Dr CHUI W<strong>in</strong>g-hoWilliamAssociateConsultantDepartment of General AdultPsychiatry, Castle Peak HospitalFidelity Scale for the Community Psychiatric Serviceof the New Territories West ClusterSPP-P1.14Ms CHUNGYuen-manJoseph<strong>in</strong>eNurseConsultantTrauma and Emergency Centre,Pr<strong>in</strong>ce of Wales HospitalCont<strong>in</strong>uous Quality Improvement Measures forShorten<strong>in</strong>g Door-to-needle Time (DTNT) for Patientswith ST-elevation Myocardial Infraction (STEMI) <strong>in</strong> theAccident and Emergency DepartmentSPP-P1.15Miss FONGSanneSeniorOccupationalTherapistOccupational TherapyDepartment, Pr<strong>in</strong>cess MargaretHospitalCost Effectiveness of Early Return to Home withOxygen Therapy for Preterm Babies with ChronicLung DiseaseSPP-P1.16 Dr HUI Elsie Chief of Service Medical and Geriatrics Unit,Shat<strong>in</strong> HospitalA Geriatric Service for End-of-life Patients Resid<strong>in</strong>g <strong>in</strong>Residential Care Homes Dur<strong>in</strong>g W<strong>in</strong>ter SurgeSPP-P1.17Dr KO Wai-sanFannyAssociateConsultantDepartment of Medic<strong>in</strong>e andTherapeutics, Pr<strong>in</strong>ce of WalesHospitalChronic Obstructive Pulmonary Disease (COPD) Care<strong>Programme</strong> Can Reduce Readmissions and InpatientBed DaysSPP-P1.18 Ms MC NG RegisteredNurseSPP-P1.19 Dr LAI Loretta AssociateConsultantTuberculosis and Chest Unit,Grantham HospitalDepartment of Family Medic<strong>in</strong>eand Primary Health Care,Kowloon East ClusterGrantham Hospital: Early Visit <strong>Programme</strong> for ChronicLung Diseases Patients with ExacerbationCan We Reduce Referrals to Medical SpecialistOutpatient Cl<strong>in</strong>ic? — an Audit on Referral <strong>in</strong> a GeneralOutpatient Cl<strong>in</strong>ic <strong>in</strong> Kowloon East Cluster
40HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P1 – Enhanc<strong>in</strong>g Healthcare DeliveryLocation Name Post Institution Topic of PresentationSPP-P1.20SPP-P1.21Mr LAI W<strong>in</strong>g-takMikeMr LEE CheukkiuJohnsonDepartmentManagerAssistant SocialWork OfficerSPP-P1.22 Dr LEE Hon-m<strong>in</strong>g AssociateConsultantSPP-P1.23Dr DAI Lok-kwanDavidConsultantRadiology Department, TuenMun HospitalMedical Social Services, YanChai HospitalIntensive Care Unit, Tuen MunHospitalCentral Committee forCompla<strong>in</strong>ts Management andPatient Engagement, HospitalAuthorityEnhancement of Patient Data Privacy <strong>in</strong> ClusterRadiology ServicePre-admission Discharge and Care Plann<strong>in</strong>g Model ofMedical Social Services for Total Jo<strong>in</strong>t ReplacementService of Yan Chai HospitalRestra<strong>in</strong>t M<strong>in</strong>imisation ProjectMediation Towards Positive Patient ExperienceSPP-P1.24Mr LEUNG KwokkuenTerenceAdvancedPractice NurseDepartment of Surgery, NorthDistrict HospitalNurse-led Rubber Band Ligation of HaemorrhoidsShortens Patient’s Wait<strong>in</strong>g Time of ProcedureArrangement and Follow-upSPP-P1.25Ms LEUNG YuenwaAdvancedPractice NurseDivision of Cardiology,Department of Medic<strong>in</strong>e andGeriatrics, United ChristianHospitalEarlier Warfar<strong>in</strong> Titration — Better or Worse <strong>in</strong>Prevent<strong>in</strong>g Bleed<strong>in</strong>g or Thromboembolic Events?SPP-P1.26 Dr LUI Ka-luen ResidentSpecialistDepartment of Medic<strong>in</strong>e andGeriatrics, Tuen Mun HospitalOutcome Follow<strong>in</strong>g Implementation of a LocalDepartment Protocol on the Management of AcuteUpper Gastro<strong>in</strong>test<strong>in</strong>al Bleed<strong>in</strong>gSPP-P1.27Mr MAK Chu-faiTrevorPharmacistDepartment of Pharmacy,Pamela Youde NethersoleEastern HospitalImpact of Pharmacist-led Anticoagulation Cl<strong>in</strong>icat Pamela Youde Nethersole Eastern Hospitalon Patients’ Anticoagulation Control and Cl<strong>in</strong>icalOutcomesSPP-P1.28Dr NG H<strong>in</strong>-poBobbySeniorOccupationalTherapistOccupational TherapyDepartment, Kowloon CentralClusterManagement of Chronic Obstructive PulmonaryDiseases <strong>in</strong> Primary Care Sett<strong>in</strong>gs — F<strong>in</strong>d<strong>in</strong>gs from aCohort StudySPP-P1.29 Ms NG Mei-l<strong>in</strong>g Ward Manager Department of Surgery, Ruttonjeeand Tang Shiu K<strong>in</strong> HospitalsEvaluate the Nurs<strong>in</strong>g Service of Early Discharge AfterBreast Cancer SurgerySPP-P1.30Ms TAM Chui-yuk AdvancedPractice NurseDepartment of Obstetricsand Gynecology, Kwong WahHospitalIncorporat<strong>in</strong>g Multi-modality Non-pharmacologicalLabour Pa<strong>in</strong> Relief <strong>in</strong> Rout<strong>in</strong>e Cl<strong>in</strong>ical Sett<strong>in</strong>g —Anecdotal Experience of a Local Regional HospitalSPP-P1.31 Mr HUI Kenny CorporateF<strong>in</strong>anceManager IF<strong>in</strong>ancial Development andPlann<strong>in</strong>g, F<strong>in</strong>ance Division,Hospital AuthorityDevelop<strong>in</strong>g Casemix Cost<strong>in</strong>g Review Mechanism forCompleteness, Validity and Accuracy (CVA)SPP-P1.32Mr WONG Fu-yanThomasPhysiotherapistIPhysiotherapy Department,Kowloon HospitalEffectiveness of Hydrotherapy <strong>Programme</strong> for Patientwith Severe Osteoarthritis KneeSPP-P1.33Dr WONG KamcheungSenior MedicalOfficerDepartment of Tuberculosis andChest, Wong Tai S<strong>in</strong> HospitalWritten Action Plan and Telephone Hotl<strong>in</strong>e Supportto Reduce Hospital Readmission <strong>in</strong> Patients withChronic Obstructive Pulmonary DiseaseSPP-P1.34Miss WU HiumanCarmenOptometristDepartment of Family Medic<strong>in</strong>e,New Territories East ClusterA Review of Structured Diabetic Ret<strong>in</strong>opathyScreen<strong>in</strong>g <strong>Programme</strong> <strong>in</strong> General Outpatient Cl<strong>in</strong>ics <strong>in</strong>New Territories East ClusterSPP-P1.35Mr TANG H<strong>in</strong>gwanStephenNurs<strong>in</strong>g OfficerIntensive Care Unit, Alice Ho MiuL<strong>in</strong>g Nethersole HospitalCl<strong>in</strong>ical Competence Enhancement Tra<strong>in</strong><strong>in</strong>g<strong>Programme</strong> on Integrated Ventilator Wean<strong>in</strong>g<strong>Programme</strong>SPP-P1.36Mr YAU CheukngokDanielNurse SpecialistGeriatric Day Hospital andMedical Rehabilitation Centre,Haven of Hope HospitalConsolidat<strong>in</strong>g Post-discharge Healthcare for ElderlyPatients through Nurs<strong>in</strong>g Case Management of theIntegrated Care Model Service: Experience of theTseung Kwan O Hospital and Haven of Hope HospitalTeam
Poster PresentationsSPP-P1 – Enhanc<strong>in</strong>g Healthcare DeliveryService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P1.37SPP-P1.38Miss YEE ShunwahAmyMs YEUNGChun-fongAdvancedPractice NurseAdvancedPractice NurseSPP-P1.39 Ms YIP Sel<strong>in</strong>a PhysiotherapistIDepartment of Medic<strong>in</strong>e, QueenMary HospitalDepartment of Surgery, PamelaYoude Nethersole EasternHospitalPhysiotherapy Department,Kowloon HospitalCollaboration Between Integrated Diabetes CareCentre, Queen Mary Hospital and Cardiac Medic<strong>in</strong>eUnit, Grantham Hospital on Diabetic ComplicationsAssessment and Treatment Intensification <strong>Programme</strong>Nurse-led Pre-admission Screen<strong>in</strong>g <strong>Programme</strong> forUrological OperationA Comprehensive Physiotherapy Outpatient Tra<strong>in</strong><strong>in</strong>g<strong>Programme</strong> <strong>in</strong> Kowloon Hospital Enhanced theMobility Level and Ambulatory Status for Patients withSp<strong>in</strong>al Cord Injury41HOSPITAL AUTHORITY CONVENTION 2013SPP-P1.40 Dr YU Pui-hang Medical Officer Family Medic<strong>in</strong>e and PrimaryHealth Care, Tuen Mun HospitalLipid Control <strong>in</strong> Diabetes Mellitus (DM) Patients<strong>in</strong> New Territories West Cluster (NTWC) GeneralOutpatient Cl<strong>in</strong>ics (GOPC): What Have We Done toPrevent Macrovascular Complications
42HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P2 – Consolidat<strong>in</strong>g Service ProvidersLocation Name Post Institution Topic of PresentationSPP-P2.1SPP-P2.2Dr CHAK WaikwongMr CHAN ChunkitJackyAssociateConsultantRegisteredNurseDepartment of Paediatrics andAdolescent Medic<strong>in</strong>e, Tuen MunHospitalAccident and Emergency Tra<strong>in</strong><strong>in</strong>gCentre, Tang Shiu K<strong>in</strong> HospitalMulti-discipl<strong>in</strong>ary Management <strong>Programme</strong> ofPaediatric Refractory Epilepsy <strong>in</strong> New Territories WestCluster – a Holistic Longitud<strong>in</strong>al Care from Hospital toCommunity: A Cl<strong>in</strong>cal Audit of Seizure, Cognitive andPsycho-behavioural OutcomeEffectiveness of the Advanced Stroke Life SupportCourse (ASLS) with Standardised Patient Simulationfor Inter-professional Healthcare Providers <strong>in</strong> HongKongSPP-P2.3Mr CHAN ChunkitJackyRegisteredNurseAccident and Emergency Tra<strong>in</strong><strong>in</strong>gCentre, Tang Shiu K<strong>in</strong> HospitalSimulation-based Hong Kong Neonatal Resuscitation<strong>Programme</strong> and Debrief<strong>in</strong>g Video DatabaseSPP-P2.4 Dr CHAN K<strong>in</strong>-wai AssociateConsultantFamily Medic<strong>in</strong>e and PrimaryHealth Care Service, KowloonWest ClusterSignificant Reduction of Surgical Specialist OutpatientWait<strong>in</strong>g Time through Collaboration Effort of FamilyMedic<strong>in</strong>e and Department of SurgerySPP-P2.5Ms CHAN SuetkaConnieAdvancedPractice NurseDepartment of Cl<strong>in</strong>ical Oncology,Tuen Mun HospitalNurtur<strong>in</strong>g Support<strong>in</strong>g Staff <strong>in</strong> Palliative Team throughEnhancement <strong>Programme</strong>SPP-P2.6Ms CHENG KapuiAssistant SocialWork OfficerDepartment of Family Medic<strong>in</strong>eand General Outpatient Cl<strong>in</strong>ic,Kowloon Central ClusterOne-year Outcome of Integrated Mental Health<strong>Programme</strong> (IMHP) for Patients with Common MentalDisorders Managed <strong>in</strong> Kowloon Central Cluster FamilyMedic<strong>in</strong>e and General Outpatient Cl<strong>in</strong>icsSPP-P2.7Ms CHEUNG PochuTeresaPhysiotherapistIIDepartment of Physiotherapy,Tuen Mun HospitalEvaluation of a Comprehensive Empower<strong>in</strong>g Preoperativeand Post-operative PhysiotherapyManagement <strong>Programme</strong> for Back Pa<strong>in</strong> PatientsSPP-P2.8Ms WU Bo-bikBonnieSenior Nurs<strong>in</strong>gOfficerHealth Resource Centre, NorthDistrict HospitalA Report on Community Health Promotion Project – FallPrevention 步 步 平 安SPP-P2.9Ms CHONG WaiwahJoanneAdvancedPractice NurseSpecialist OutpatientDepartment, Pamela YoudeNethersole Eastern HospitalShorten Patient Wait<strong>in</strong>g Time of Community Nurs<strong>in</strong>gService Referral Procedure for Old Cases Who Needfor Blood Tak<strong>in</strong>g or Injection <strong>in</strong> Specialist OutpatientDepartmentSPP-P2.10Dr FOK K<strong>in</strong>g-takDouglasAssociateConsultantDepartment of Anaesthesiologyand Operat<strong>in</strong>g Theatre Services,Queen Elizabeth HospitalWhere We Are Now: Two Years Review of a NewMulti-discipl<strong>in</strong>ary Service <strong>in</strong> Queen Elizabeth Hospital– Transcatheter Aortic Valve Implantation (TAVI)Outcome Comparison with Conventional SurgicalAortic Valve Replacement (SAVR)SPP-P2.11Dr FUNG Honsh<strong>in</strong>gAssociateConsultantDepartment of Radiology andImag<strong>in</strong>g, Queen ElizabethHospitalHybrid Procedure for Head and Neck VascularMalformation: A Novel, One-stop Multi-discipl<strong>in</strong>aryTreatment for Better Patient Journey and OutcomeSPP-P2.12 Ms HO Oi-man Ward Manager Hospital Authority InfectiousDisease CentreCross-facility Simulation-based Exercise for InfectiousDisease Outbreak Emergency PreparednessSPP-P2.13 Miss KO Ka-wai RegisteredNurseAccident and EmergencyDepartment, United ChristianHospitalThe Effects of Nurse-<strong>in</strong>itiated Nasogastric TubeInsertion on the Service Provision <strong>in</strong> Accident andEmergency DepartmentSPP-P2.14Ms KWAN SzehanJoanAdvancedPractice NurseCentral Nurs<strong>in</strong>g Division, KwongWah Hospital4S- Strategic Tra<strong>in</strong><strong>in</strong>g <strong>Programme</strong> (Stimulation, StaffCollaboration, Simulation, Self-susta<strong>in</strong><strong>in</strong>g) to Enhancethe Effectiveness and Safeness of Nurs<strong>in</strong>g Practicefor Newly Graduated Nurses <strong>in</strong> Cl<strong>in</strong>ical Sett<strong>in</strong>gsSPP-P2.15 Dr LAM Bosco AssociateConsultantDepartment of Pathology(Microbiology), Pr<strong>in</strong>cessMargaret HospitalTowards Zero Tolerance for Catheter-relatedBloodstream Infection: Comb<strong>in</strong><strong>in</strong>g Hospital-wide andTargeted StrategiesSPP-P2.16Ms LAM Choip<strong>in</strong>gAdvancedPractice NurseDepartment of Surgery, Pr<strong>in</strong>ce ofWales HospitalThe Role of a Colorectal Specialty Nurse <strong>in</strong> a FasttrackPerioperative <strong>Programme</strong> <strong>in</strong> Hong KongSPP-P2.17 Ms LAU Mei-l<strong>in</strong>g RegisteredNurseDepartment of Medic<strong>in</strong>e andGeriatric, United ChristianHospitalDevelopment of Delirium Care Model <strong>in</strong> AcuteGeriatric Ward
Poster PresentationsSPP-P2 – Consolidat<strong>in</strong>g Service ProvidersService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P2.18Ms LAW Manch<strong>in</strong>gNurseConsultantRenal Unit, Department ofMedic<strong>in</strong>e and Therapeutics,Pr<strong>in</strong>ce of Wales HospitalSPP-P2.19 Dr LEE Kit-yan Resident Cheung Sha Wan Jockey ClubGeneral Outpatient Cl<strong>in</strong>ic,Department of Family Medic<strong>in</strong>eand Primary Health Care,Kowloon West ClusterSPP-P2.20Dr DAI Lok-kwanDavidClusterCoord<strong>in</strong>atorPatient Relations andEngagement Committee, NewTerritories East ClusterA Collaborative Project to Support Peritoneal DialysisPatients <strong>in</strong> the CommunityIs Chronic Obstructive Pulmonary DiseaseAssessment Test (CAT) Applicable <strong>in</strong> Our DailyPractice?Empower<strong>in</strong>g a Trust<strong>in</strong>g Partnership43HOSPITAL AUTHORITY CONVENTION 2013SPP-P2.21Miss LEUNGShun-wah AvaAdvancedPractice NurseCentral Nurs<strong>in</strong>g Division, KwongWah HospitalA Multi-faceted Adult Resuscitation Tra<strong>in</strong><strong>in</strong>g forNurses <strong>in</strong> Kwong Wah HospitalSPP-P2.22 Dr KU Tak-loi AssociateConsultantDepartment of Paediatrics andAdolescent Medic<strong>in</strong>e, Tuen MunHospitalTransitional Care <strong>Programme</strong> for PaediatricThalassemia Major PatientsSPP-P2.23Ms LO Suk-l<strong>in</strong>gConnieAdvancedPractice NurseDepartment of Central Nurs<strong>in</strong>gDivision, North District HospitalCar<strong>in</strong>g Start from Orientation – One-day Orientation <strong>in</strong>North District HospitalSPP-P2.24Dr LUK Ka-hayJamesConsultantDepartment of Medic<strong>in</strong>e andGeriatrics, Fung Yiu K<strong>in</strong>gHospitalResidential Care Homes with and without W<strong>in</strong>terSurge <strong>Programme</strong> – Are There Any Differences?SPP-P2.25Ms POONChung-fanAdvancedPractice NurseDepartment of Obstetrics andGynaecology, Queen ElizabethHospitalAn Audit on the Performance of Down SyndromeScreen<strong>in</strong>g Service by Midwives – an Example toProvide Quality Service Despite Heavy WorkloadSPP-P2.26 Ms WONG T<strong>in</strong>a HealthInformaticianHealth Informatics Section,Hospital Authority Head OfficeRadiological Image Distribution Across the PublicprivateInterface <strong>in</strong> Hong Kong: Results of a Four-yearProjectSPP-P2.27 Dr SY WONG Consultant Department of InformationTechnology and InformationSystem, Hong Kong West ClusterEnhancement of Data Security with Hong Kong WestCluster Web DriveSPP-P2.28Dr SIN M<strong>in</strong>gchuenAssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Healthcare, PamelaYoude Nethersole EasternHospitalService Review on Integrated Mental Health<strong>Programme</strong> <strong>in</strong> Hong Kong East ClusterSPP-P2.29Dr SIU Wei-manBonnieAssociateConsultantHospital Chief Executive, Chiefof Services and Cl<strong>in</strong>ical ServicesDepartment, Castle PeakHospitalMental Health Promotion <strong>in</strong> Hong Kong: A Wayto Defeat Stigmatisation and Enhance the EarlyIntervention of Mental Illness <strong>in</strong> the CommunitySPP-P2.30 Dr SZE Hon-ho AssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Healthcare, QueenMary HospitalIntroduction of Tra<strong>in</strong><strong>in</strong>g Workshops on Enhanc<strong>in</strong>gCl<strong>in</strong>ical and Communication skills for PrimaryHealthcare WorkersSPP-P2.31 Dr TONG Man-kit Resident Department of Ophthalmology,United Christian HospitalAn Implementation of Computerised Laser Book<strong>in</strong>gSystem to Reduce Appo<strong>in</strong>tment Lead TimesSPP-P2.32Miss WONG SiuchongJaniceMortuaryAttendant/ Officer /TechnicianHospital Authority Lions EyeBankThe Effects of Cornea Preservation Time on One-yearPost-transplantation Cl<strong>in</strong>ical OutcomesSPP-P2.33 Ms WONG Ka-po AdvancedPractice NurseEldery Suicide Prevention<strong>Programme</strong>, New Territories EastClusterRelationship Between Health Status and Burden ofDementia Caregivers <strong>in</strong> Hong KongSPP-P2.34 Miss WONG Katie HealthInformaticsAnalystHealth Informatics Division,Hospital Authority Head OfficeEnhance Cl<strong>in</strong>icians’ Capability for and Acceptanceof Filmless Implementation by Tra<strong>in</strong><strong>in</strong>g Sessions: ACross-sectional Study
44HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P2 – Consolidat<strong>in</strong>g Service ProvidersLocation Name Post Institution Topic of PresentationSPP-P2.35 Ms SC WONG Ward Manager Department of Obstetrics andGynaecology, Pr<strong>in</strong>cess MargaretHospitalSPP-P2.36SPP-P2.37Mr TANG H<strong>in</strong>gwanStephenMs YEUNG Saul<strong>in</strong>gStephanieNurs<strong>in</strong>g OfficerSenior HospitalAdm<strong>in</strong>istratorIntensive Care Unit, Alice Ho MiuL<strong>in</strong>g Nethersole HospitalCommunications and CommunityRelations Section, NewTerritories East ClusterTeam Approach on Prevention of Fall <strong>Programme</strong> <strong>in</strong>Postnatal WardNurs<strong>in</strong>g Management Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Intensive Care Unit –Cross Over the S<strong>in</strong>gle-loop Learn<strong>in</strong>gUs<strong>in</strong>g Social Media to Enhance InternalCommunication <strong>in</strong> New Territories East Cluster – Trialand EvaluationSPP-P2.38Mr YIP Chunm<strong>in</strong>gKennethManagerOperations Research Section,Hong Kong West ClusterQueen Mary Hospital Uses Discrete-event Simulationto Plan its Centralised Phlebotomy Service for theSpecialist Outpatient DepartmentSPP-P2.39 Dr YIP Siu-leung Resident Department of Orthopaedicsand Traumatology, Kwong WahHospitalIntegrated Traditional Ch<strong>in</strong>ese Medic<strong>in</strong>e/WesternMedic<strong>in</strong>e Treatment for Serious Diabetic FootUlceration – Kwong Wah Hospital ExperienceSPP-P2.40Ms YUNG Waiy<strong>in</strong>gJanetAdvancedPractice NurseDepartment of Ear, Nose andThroat, Pamela Youde NethersoleEastern HospitalAudit and Satisfaction Survey on Ear Syr<strong>in</strong>g<strong>in</strong>gService <strong>in</strong> Ear, Nose and Throat Special Cl<strong>in</strong>ic – “Ear”
Poster PresentationsSPP-P3 – Consolidat<strong>in</strong>g Service ReceiversService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P3.1Ms CHAN Choiy<strong>in</strong>gDeputis<strong>in</strong>gAdvancedPractice NurseSPP-P3.2 Dr CHAN David AssociateConsultantSPP-P3.3Dr CHAN K<strong>in</strong>sh<strong>in</strong>gBillPhysiotherapistIDepartment of Medic<strong>in</strong>e, NorthDistrict HospitalDepartment of Family Medic<strong>in</strong>eand General Outpatient Cl<strong>in</strong>ic,Kowloon Central ClusterPhysiotherapy Department,Kowloon HospitalImpact of Respiratory Hotl<strong>in</strong>e on Patients andHealthcare UtilisationEnhancement of Public Primary Care Service <strong>in</strong>Kowloon Central Cluster Family Medic<strong>in</strong>e and GeneralOutpatient Cl<strong>in</strong>ic (A New Initiative of Multi-discipl<strong>in</strong>aryPatient Care Collaboration)Randomised Controlled Trial of TranscutaneousElectrical Nerve Stimulation (Tens) and Task-relatedTrunk Tra<strong>in</strong><strong>in</strong>g (TRTT) for Improv<strong>in</strong>g Balance andMobility <strong>in</strong> Subjects with Chronic Stroke45HOSPITAL AUTHORITY CONVENTION 2013SPP-P3.4 Dr CHAN K<strong>in</strong>-wai AssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care,Kowloon West ClusterA Survey on the Type 2 Diabetes Mellitus (DM)Patients’ Understand<strong>in</strong>g about the Proper Monitor<strong>in</strong>gof DM ControlSPP-P3.5 Dr CHAN K<strong>in</strong>g Chief of Service Department of Family Medic<strong>in</strong>eand General Outpatient Cl<strong>in</strong>ic,Kowloon Central ClusterBr<strong>in</strong>g<strong>in</strong>g Better Health to Our Community 2012SPP-P3.6 Dr CHAN Laam AssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care, NewTerritories West ClusterA Review of Ophthalmologist Referrals <strong>in</strong> an ElderlyEye Assessment <strong>Programme</strong>SPP-P3.7 Dr CHAN May Pharmacist Department of Pharmacy, TseungKwan O HospitalA Pilot Study of Chronic Obstructive PulmonaryDisease (COPD) Self-management <strong>Programme</strong> atTseung Kwan O HospitalSPP-P3.8Ms CHAN Y<strong>in</strong>hanDeputy WardManagerNurs<strong>in</strong>g Department, ChesireHome, Shat<strong>in</strong>Resident Self-medication <strong>Programme</strong> (Pilot<strong>Programme</strong>)SPP-P3.9Mr CHAU ShunlungStanleyOccupationalTherapist IOccupational TherapyDepartment, Pr<strong>in</strong>cess MargaretHospitalHome Non-<strong>in</strong>vasive Ventilation with DomiciliaryOccupational Therapy Support Improves Cl<strong>in</strong>icalOutcomesSPP-P3.10Mr CHEUNG PoyanEdmundPharmacistPharmacy Department, Pr<strong>in</strong>cessMargaret HospitalA Pharmacist-led Medication Management andCompliance Cl<strong>in</strong>ic to Enhance Primary Care <strong>in</strong> aGeneral Outpatient Sett<strong>in</strong>gSPP-P3.11Ms CHIM Chunk<strong>in</strong>gWard ManagerCommunity Outreach ServiceTeam, North District HospitalProtected Time to Optimise Chronic Disease Selfmanagement:An Enhanced Community Nurs<strong>in</strong>gService ModelSPP-P3.12Miss CHOW SomanRegisteredNurseDepartment of CardiothoracicSurgery, Queen ElizabethHospitalWarfar<strong>in</strong> Management for Patients Who UndergoneMechanical Valve Replacement: To Increase thePatient's Knowledge, Drug Compliance and SafetySPP-P3.13 Dr CHU M<strong>in</strong>g-chi AssociateConsultantPa<strong>in</strong> Management Centre, AliceHo Miu L<strong>in</strong>g Nethersole HospitalImproved Work Rate and Reduced Medical Utilisationwith Integrated Pa<strong>in</strong> Management <strong>Programme</strong>SPP-P3.14Ms CHUNG MansumTeresaAdvancedPractice NurseDepartment of General AdultPsychiatry, Castle Peak HospitalPatient Engagement <strong>Programme</strong>: Mental HealthEducation for Patient <strong>in</strong> Admission Ward E201 ofCastle Peak Hospital 精 神 健 康 教 育 講 座SPP-P3.15 Ms LAU Wai-ha AdvancedPractice NurseDepartment of Family Medic<strong>in</strong>e,New Territories East ClusterPicture Instructions Can Help Elderly Patients withType 2 Diabetes to Overcome Illiterate Barrier forInitiat<strong>in</strong>g Insul<strong>in</strong> Therapy <strong>in</strong> Primary Care Sett<strong>in</strong>gSPP-P3.16 Mr KWAN Yu-on Podiatrist I Department of Podiatry, Pr<strong>in</strong>cessMargaret HospitalA Pilot <strong>Programme</strong> on Multi-discipl<strong>in</strong>ary Diabetic FootServiceSPP-P3.17 Ms LH YIP RegisteredNurseDepartment of Paediatrics andAdolescent Medic<strong>in</strong>e, Tuen MunHospitalCare for a Life Time: Epilepsy Transition <strong>Programme</strong>SPP-P3.18 Miss LAI Eva Pharmacist Ngau Tau Kok General OutpatientCl<strong>in</strong>icA Randomised Controlled Study on the Effect ofCounsel<strong>in</strong>g Session Provided by Pharmacist onMetered-dose Inhaler (MDI) Technique AmongPatients <strong>in</strong> General Outpatient Cl<strong>in</strong>ic
46HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P3 – Consolidat<strong>in</strong>g Service ReceiversLocation Name Post Institution Topic of PresentationSPP-P3.19Ms LEUNG Wail<strong>in</strong>Ward ManagerSPP-P3.20 Mr LAW Kei-chun AdvancedPractice NurseSPP-P3.21Dr FUNG Ch<strong>in</strong>gmanJennyManagerDepartment of Obstetrics andGynaecology, Kwong WahHospitalDepartment of Cl<strong>in</strong>ical Oncology,Pr<strong>in</strong>ce of Wales HospitalNew Territories East CommunityRehabilitation Day Center, SAHK( 香 港 耀 能 協 會 )Post-hysterectomy Patient Support GroupA Cont<strong>in</strong>uous Quality Improvement (CQI) Cancer Pa<strong>in</strong>Education <strong>Programme</strong> to Enhance Pa<strong>in</strong> Management<strong>in</strong> the Oncology UnitCont<strong>in</strong>uum of Care for Orthopedic Patient – fromHospital to Community through Cl<strong>in</strong>ical PathwaySPP-P3.22Dr LEE CheukkwongConsultantHong Kong Red Cross BloodTransfusion ServiceCan We Model Our Blood Collection Based onDonation Behaviour?SPP-P3.23 Miss SM LEUNG AdvancedPractice NurseSchool of Nurs<strong>in</strong>g, CaritasMedical CentrePrepar<strong>in</strong>g Spousal Caregivers for the Death of TheirLoved One with Advanced Cancer <strong>in</strong> Hong Kong:Round<strong>in</strong>g up Relational and Family Bus<strong>in</strong>essSPP-P3.24Mrs LEUNG Waim<strong>in</strong>gAdvancedPractice NurseDepartment of Cl<strong>in</strong>ical Oncology,Queen Elizabeth HospitalEvaluat<strong>in</strong>g the Effectiveness of the Nurs<strong>in</strong>g<strong>Programme</strong> of Edema Management <strong>in</strong> AdvancedCancer PatientsSPP-P3.25 Miss LO Lubie Pharmacist Department of Pharmacy, TseungKwan O HospitalPatients’ Knowledge about Medications – a CrosssectionalSurvey on How We Can Empower OurPatientsSPP-P3.26 Dr LUI Col<strong>in</strong> AssociateConsultantDepartment of Medic<strong>in</strong>e, TseungKwan O HospitalA Protocol-driven Thrombolytic Service for IschaemicStroke PatientsSPP-P3.27 Mr LUI Siu-fung Ward Manager Department of Psychiatry,Pamela Youde NethersoleEastern HospitalEducational <strong>Programme</strong> for the Prevention of PressureUlcers: The Work of the Psychogeriatric Nurs<strong>in</strong>g TeamSPP-P3.28Ms MAK Man-yuMandySeniorPhysiotherapistPhysiotherapy Department, TuenMun HospitalDoes a Navigat<strong>in</strong>g Exercise <strong>Programme</strong> Lead to anActive Life Style <strong>in</strong> Diabetic Patients?SPP-P3.29 Ms MAK Po-kit NurseConsultantNurs<strong>in</strong>g Services Division,Ruttonjee and Tang Shiu K<strong>in</strong>HospitalFrom Do-not-resuscitation Order to End-of-LifeCare for the Elders <strong>in</strong> the Department of Geriatrics,Ruttonjee and Tang Shiu K<strong>in</strong> HospitalsSPP-P3.30 Ms NG Yan-lai OccupationalTherapist IOccupational TherapyDepartment, MacLehose MedicalRehabilitation CentreCl<strong>in</strong>ical Application of the Functional PredictionEquation <strong>in</strong> the Rehabilitation Phase of Geriatric HipFracture PathwaySPP-P3.31Miss NG Yik-s<strong>in</strong>JessieOptometristDepartment of Family Medic<strong>in</strong>eand Primary Health Care, NewTerritories West ClusterThe Prevalence and Cause of Visual Impairment <strong>in</strong>Elderly <strong>in</strong> Our Local CommunitySPP-P3.32 Ms TAM On-yan PhysiotherapistIISPP-P3.33 Ms TO Oi-k<strong>in</strong>g AdvancedPractice NurseDepartment of Physiotherapy,Tuen Mun HospitalCommunity Nurs<strong>in</strong>g Service,Kwong Wah HospitalEvaluation of a Return-to-Work Cognitive-BehaviouralBased Physiotherapy Back Rehabilitation <strong>Programme</strong>Hospital-community Partnership <strong>Programme</strong> forPatients with StomaSPP-P3.34Ms TONG MeihoiAdvancedPractice NurseCommunity Outreach ServiceTeam, North District HospitalImplementation of an Innovative “Puff Visual Chart”to Enhance Puff Compliance of Chronic ObstructivePulmonary Disease (COPD) Patients <strong>in</strong> the CommunitySPP-P3.35Ms TSANG WaiyiAdvancedPractice NurseMedic<strong>in</strong>e and GeriatricsDepartment, United ChristianHospitalTransitional Care Model for the High Risk Elderly withHeart FailureSPP-P3.36 Prof WONG Eliza Professor Division of Health System, Policyand Management, The JockeyClub School of Public Healthand Primary Care, The Ch<strong>in</strong>eseUniversity of Hong KongWhat are the Possible Determ<strong>in</strong>ants of InpatientSatisfaction and Experience <strong>in</strong> Public Hospital CareSett<strong>in</strong>g?
Poster PresentationsSPP-P3 – Consolidat<strong>in</strong>g Service ReceiversService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P3.37SPP-P3.38SPP-P3.39Ms WONG ManshuMabelDr WONG H<strong>in</strong>glamMs WONG Tzew<strong>in</strong>gRegisteredNurseResidentNurseConsultantNeonatal Intensive Care Unit,Queen Elizabeth HospitalDepartment of Family Medic<strong>in</strong>eand Primary Health Care, UnitedChristian HospitalDepartment of Surgery, Pr<strong>in</strong>ce ofWales HospitalEvaluation of a Family-centred Intervention <strong>in</strong> aSpecial Care Baby Unit: Parental Outcomes andNurs<strong>in</strong>g Staff Feedback on Kangaroo CareAn Evidence-based Cl<strong>in</strong>ical Audit on the Process ofCare on Smok<strong>in</strong>g Cessation Intervention to Patients<strong>in</strong> a Public Family Medic<strong>in</strong>e Specialist Cl<strong>in</strong>ic <strong>in</strong> HongKongSk<strong>in</strong> Pruritus Among Patients with Recovery fromBurn Injury47HOSPITAL AUTHORITY CONVENTION 2013SPP-P3.40Miss CHAN LaionProsthetist-Orthotist IIProsthetic-Orthotic Department,Tuen Mun HospitalEnhancement of Patient and Carer Education toImprove the Compliance of Hip Protectors for Patientswith High Risk of Fall
48HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P4 – Quality and Safety <strong>in</strong> Healthcare ILocation Name Post Institution Topic of PresentationSPP-P4.1 Mr CHAN David Manager Central Quality AssuranceInspection Team, Bus<strong>in</strong>essServices and SupportDepartment, Hospital AuthorityHead OfficeSPP-P4.2 Dr CHAN Jeffrey Resident Department of Ophthalmology,United Christian HospitalSPP-P4.3 Mr FU Benedict Senior HospitalManagerAdm<strong>in</strong>istrative ServicesDepartment, Pok Oi HospitalNo Product is Ever Risk Free — How CentralQuality Assurance Inspection Team to Enhance andSafeguard the Quality of Medical Device Us<strong>in</strong>g <strong>in</strong>Hospital Authority InstitutionThe Use of a Customised Template <strong>in</strong> Cl<strong>in</strong>ical Inboxfor Interdepartmental Inpatient OphthalmologyConsultationImprov<strong>in</strong>g Patients’ Privacy/Dignity and Safety Dur<strong>in</strong>gNon-emergency Ambulance Transfer Service (NEATS)Discharge by Sett<strong>in</strong>g Up of NEATS Patients Wait<strong>in</strong>gLoungeSPP-P4.4 Mr CM LAM RadiationTherapist ICl<strong>in</strong>ical Oncology Department,Tuen Mun HospitalImprove Treatment Efficiency for Radiation Treatmentof Prostatic Cancer through Additional Rectal DoseEstimation ChartSPP-P4.5Ms CHANG Kay<strong>in</strong>SandyDietitianDietetics Department, Pr<strong>in</strong>ce ofWales HospitalQuality Improvement <strong>in</strong> Milk Formulae RoomSPP-P4.6Ms CHENG Laip<strong>in</strong>gAdvancedPractice NurseDepartment of Medic<strong>in</strong>e andRehabilitation, Tung Wah EasternHospitalCl<strong>in</strong>ical Enhancement for Quality Improvement<strong>Programme</strong>SPP-P4.7 Mr CHING Jan AdvancedPractice NurseUrology Unit, Department ofSurgery, Tseung Kwan O HospitalUrology Nurse Cl<strong>in</strong>ic — Benign Prostatic Hyperplasia(BPH) Triage Cl<strong>in</strong>icSPP-P4.8 Mr HO Chi-wai NurseConsultantSPP-P4.9 Ms HO Lai-p<strong>in</strong>g AdvancedPractice NurseDepartment of Surgery, PamelaYoude Nethersole EasternHospitalDepartment of Paediatrics,Pr<strong>in</strong>ce of Wales HospitalQuality and Safety <strong>in</strong> Tubes Management — the “Seethrough”Film Dress<strong>in</strong>g on Biliary TubesThe Efficacy of Facilitated Swaddl<strong>in</strong>g for Reliev<strong>in</strong>gProcedural Pa<strong>in</strong> of Heelstick <strong>in</strong> Premature Infants: APilot StudySPP-P4.10Mr HUANG WenhaiKev<strong>in</strong>HospitalAdm<strong>in</strong>istrator IIPlann<strong>in</strong>g and Commission<strong>in</strong>gSection, Hong Kong West ClusterEnhance Schedul<strong>in</strong>g of Phlebotomy Services <strong>in</strong> TungWah Hospital through Discrete Event SimulationModel<strong>in</strong>gSPP-P4.11 Dr CH KWOK ResidentSpecialistSPP-P4.12 Ms LAM Shuk-y<strong>in</strong> AdvancedPractice NurseDepartment of Medic<strong>in</strong>e andGeriatrics, Pr<strong>in</strong>cess MargaretHopsitalCommunity Nurs<strong>in</strong>g Service,Kowloon East ClusterElectronic Chemotherapy Protocol PrescriptionReduces Medication Errors and Conserves Time ofPhysiciansSmall Change, Big Improvement <strong>in</strong> CommunityNurs<strong>in</strong>g: Enhancement Pre-visit Preparation<strong>Programme</strong>SPP-P4.13Mr LAM WaichuenRegisteredNurseInfection Control Team, PamelaYoude Nethersole EasternHospitalEffects of Antibiotic Stewardship <strong>Programme</strong> toReduce Use of Intravenous (IV) Qu<strong>in</strong>oloneSPP-P4.14Ms LAU Sze-manMavisProsthetist-Orthotist IIDepartment of Prosthetics andOrthotics, Tuen Mun HospitalInvention Nasogastric Tube Feed<strong>in</strong>g 3D Tra<strong>in</strong><strong>in</strong>g Kit byMulti-discipl<strong>in</strong>ary Team Cooperation — Hand <strong>in</strong> Hand<strong>Programme</strong>: P^O^NSPP-P4.15 Ms LAU Queenie AdvancedPractice NurseCommunity Nurs<strong>in</strong>g Service,Kwong Wah HospitalLone Worker Management <strong>in</strong> Community Nurs<strong>in</strong>gServiceSPP-P4.16Ms LAW Manch<strong>in</strong>gNurseConsultantRenal Unit, Department ofMedic<strong>in</strong>e and Therapeutics,Pr<strong>in</strong>ce of Wales HospitalA Day Automated Peritoneal Dialysis <strong>Programme</strong>Provides Effective Services to End Stage RenalDisease PatientsSPP-P4.17 Ms LEE Pik-fan Nurs<strong>in</strong>g Officer Medic<strong>in</strong>e and GeriatricsDepartment, United ChristianHospitalProfessional Support to Ad Hoc Needs <strong>in</strong>Rheumatology Care — a Review of Telephone AdviceL<strong>in</strong>e (TAL) Service <strong>in</strong> United Christian HospitalSPP-P4.18 Ms SH LEE AdvancedPractice NurseDivision of Nephrology,Department of Medic<strong>in</strong>e andGeriatrics, Pr<strong>in</strong>cess MargaretHospitalThe Vascular Care Re-eng<strong>in</strong>eer<strong>in</strong>g (VCR) Initiative:The impact of VCR <strong>Programme</strong> on Outcomes of NewlyCreated Vascular Access
Poster PresentationsSPP-P4 – Quality and Safety <strong>in</strong> Healthcare IService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P4.19SPP-P4.20SPP-P4.21Ms LEE ShukmanDr TANG W<strong>in</strong>ghanMiss LEUNGMan-l<strong>in</strong>g GraceRadiationTherapist IResidentSpecialistAdvancedPractice NurseRadiotherapy Plann<strong>in</strong>g Section,Department of Cl<strong>in</strong>ical Oncology,Queen Elizabeth HospitalMedic<strong>in</strong>e and Geriatrics Unit,Shat<strong>in</strong> HospitalDepartment of Medic<strong>in</strong>e, PamelaYoude Nethersole EasternHospitalE-plann<strong>in</strong>g Schedule ProjectUse of Accident and Emergency Service AmongResidential Care Home for the Elderly (RCHE)Residents <strong>in</strong> End of Life Care <strong>Programme</strong>Ensur<strong>in</strong>g Medication Safety from Hospital to theCommunity <strong>in</strong> the Department of Medic<strong>in</strong>e, PamelaYoude Nethersole Eastern Hospital49HOSPITAL AUTHORITY CONVENTION 2013SPP-P4.22Ms LEUNG YungaiAdvancedPractice NurseDepartment of Obstetrics andGynaecology, Kwong WahHospitalThe Effect of Early Sk<strong>in</strong>-to-sk<strong>in</strong> Contact on ExclusiveBreastfeed<strong>in</strong>g Rate and Self-efficacy of Breastfeed<strong>in</strong>gAmong Hong Kong Ch<strong>in</strong>ese WomenSPP-P4.23Dr LEUNG YukyanRockAssociateConsultantDepartment of Pathology andCl<strong>in</strong>ical Biochemistry, QueenMary HospitalMore than a Ratio: A Review of Trauma TransfusionProtocol (TTP) <strong>in</strong> Queen Mary HospitalSPP-P4.24 Ms LI Shu-fan Ward Manager Medical Department, Tung WahHospitalImprovement of Neurodiagnostic Test Book<strong>in</strong>g <strong>in</strong> TungWah HospitalSPP-P4.25 Mr WM LING NurseConsultantDepartment of Cl<strong>in</strong>ical Oncology,Pamela Youde NethersoleEastern HospitalEstablishment of Chemotherapy Nurse Cl<strong>in</strong>ic <strong>in</strong> aLocal Cl<strong>in</strong>ical Oncology DepartmentSPP-P4.26 Ms LO Debbie HospitalAdm<strong>in</strong>istrator ISupport<strong>in</strong>g Services Department,Pr<strong>in</strong>cess Margaret HospitalA Collaborative Approach with Specialist OutpatientCl<strong>in</strong>ic: To Meet Punctuality for Medical Appo<strong>in</strong>tmentCases of Non-emergency Ambulance Transfer Service(NEATS)SPP-P4.27 Ms LUI Miranda Ward Manager Department of Paediatrics,Tseung Kwan O HospitalThe Need for a Regularly Updated Asthma Education<strong>Programme</strong> to Nurses to Enhance Patient Care andSave Resources <strong>in</strong> Paediatric PracticeSPP-P4.28 Dr YH LUI Senior MedicalOfficerDepartment of Pathology, UnitedChristian HospitalTo Improve Thyroid F<strong>in</strong>e Needle Aspiration Cytology(FNAC) Report<strong>in</strong>g with Bethesda SystemSPP-P4.29Dr LUK Ka-hayJamesConsultantDepartment of Medic<strong>in</strong>e andGeriatrics, Fung Yiu K<strong>in</strong>gHospitalPeaceful Death — End of Life Care Pathway forInpatients (EOL-CPi) <strong>in</strong> a Geriatric Step Down HospitalSPP-P4.30Ms LUK Ka-yanHelenSeniorPhysiotherapistPhysiotherapy Department,Queen Elizabeth HospitalEarly Supported Discharge After Stroke: A HomebasedPhysiotherapy Rehabilitation <strong>Programme</strong>SPP-P4.31 Mr MAN Ho-y<strong>in</strong> Senior Nurs<strong>in</strong>gOfficerNorth Lantau HospitalCommission<strong>in</strong>g Office, Pr<strong>in</strong>cessMargaret HospitalNew Concept of Ward Design <strong>in</strong> North LantauHospital — DecentralisationSPP-P4.32Mr MOK Ki-fungV<strong>in</strong>centAdvancedPractice NurseQueen Elizabeth HospitalMedical Specialty Ventilator UnitThe Effectiveness of a Nurse-implemented SedationManagement on Unplanned ExtubationSPP-P4.33 Dr MOK Y<strong>in</strong>-to Resident Accident and EmergencyDepartment, Yan Chai HospitalStudy on Cl<strong>in</strong>ical Outcomes of Trauma Patients AfterImplementation of Secondary Trauma Diversion <strong>in</strong>Two Regional Hospitals <strong>in</strong> Hong KongSPP-P4.34 Dr NG Lorna Senior MedicalOfficerFamily Medic<strong>in</strong>e and GeneralOutpatient Department, KwongWah HospitalInnovations <strong>in</strong> Mobilis<strong>in</strong>g Community Resourcesfor Susta<strong>in</strong>able Hypertension Care <strong>in</strong> Primary CareSett<strong>in</strong>gSPP-P4.35Ms NG Sau-p<strong>in</strong>gMandyRegisteredNurseInfection Control Team, Pr<strong>in</strong>cessMargaret HospitalThe Use of Tailor Design Strategy to PromoteInfluenza Immunisation Rate Among HealthcareWorkers <strong>in</strong> Pr<strong>in</strong>cess Margaret HospitalSPP-P4.36Dr SO HangkwongEricConsultantDepartment of Anaesthesiologyand Operat<strong>in</strong>g Theatre Services,Queen Elizabeth HospitalMulti-discipl<strong>in</strong>ary Approach to Enhance Operat<strong>in</strong>gTheatre Utilisation EfficiencySPP-P4.37Dr TONG ChakkwanSenior MedicalOfficerIntensive Care Unit, Pr<strong>in</strong>cessMargaret HospitalA Survey on Mechanical Ventilation <strong>in</strong> General Wards<strong>in</strong> Pr<strong>in</strong>cess Margaret Hospital
50HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P4 – Quality and Safety <strong>in</strong> Healthcare ILocation Name Post Institution Topic of PresentationSPP-P4.38 Dr TONG Macy AssociateConsultantSPP-P4.39 Mr HUI Kenny CorporateF<strong>in</strong>anceManager I(F<strong>in</strong>ancialPlann<strong>in</strong>g)Department of Oncology,Pr<strong>in</strong>cess Margaret HospitalF<strong>in</strong>ancial Development andPlann<strong>in</strong>g, F<strong>in</strong>ance Division,Hospital Authority Head OfficeSuccessful Reduction <strong>in</strong> the “Door-to-Needle Time”for Antibiotic Adm<strong>in</strong>istration <strong>in</strong> the EmergencyManagement of Chemotherapy-<strong>in</strong>duced NeutropenicFeverDevelop<strong>in</strong>g an Additional Index of Staff ProductivityUs<strong>in</strong>g Casemix InformationSPP-P4.40 Mr CHAN Denis Physiotherapist Physiotherapy Department,Ruttonjee and Tang Shiu K<strong>in</strong>HospitalsHealthy Knee Voyage: Chronic Disease ManagementModel for Knee Osteoarthritis
Poster PresentationsSPP-P5 – Quality and Safety <strong>in</strong> Healthcare IIService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P5.1 Ms AU Wai-fong AdvancedPractice NurseSPP-P5.2SPP-P5.3Miss CHAN MeiyeeMs CHAN Nar-chiNeritaDeputis<strong>in</strong>gNurs<strong>in</strong>g OfficerSeniorPhysiotherapistTuberculosis and Chest MedicalUnit, Grantham HospitalCardiac Care Unit, Department ofMedic<strong>in</strong>e, North District HospitalDepartment of Physiotherapy,Tuen Mun HospitalEnhancement of Medication SafetyKnowledge, Practice, Attitudes (K.P.A) TowardsNurse-<strong>in</strong>itiated Defibrillation <strong>in</strong> North District HospitalCardiac Care Unit (CCU)Lower Limbs Cast<strong>in</strong>g <strong>in</strong> Adjunct to Botul<strong>in</strong>ium Tox<strong>in</strong>(BTX) Injection to Improve the Gait Pattern for Patientwith Stroke51HOSPITAL AUTHORITY CONVENTION 2013SPP-P5.4 Miss WS CHAN AdvancedPractice NurseInfection Control Team,Department of Pathology, TseungKwan O HospitalSharps Injury Reduction through Education andAwareness <strong>Programme</strong>SPP-P5.5Mr CHAN WaihungWard ManagerOccupational Safety and HealthFacilitators Work<strong>in</strong>g Group, SiuLam HospitalFac<strong>in</strong>g the Challenge of Patient Transfers: Us<strong>in</strong>gCeil<strong>in</strong>g Hoist <strong>in</strong> Siu Lam HospitalSPP-P5.6Mr CHAU Ka-waiDanielPhysiotherapistIPhysiotherapy Department,Queen Elizabeth HospitalThe Effectiveness of Physiotherapy Intervention forPatients with Park<strong>in</strong>son's DiseaseSPP-P5.7Ms CHEAH PohchooPharmacistPharmacy Department, Duchessof Kent Children’s HospitalUs<strong>in</strong>g Electronic Patient Record (ePR) System toImprove Patients’ Medication Safety <strong>in</strong> a PaediatricHospital — a Pharmacist’s RoleSPP-P5.8Dr CHUChristopherSenior MedicalOfficerDepartment of Anaesthesiologyand Operat<strong>in</strong>g Services, Alice HoMiu L<strong>in</strong>g Nethersole HospitalA Cont<strong>in</strong>uous Quality Improvement (CQI) Project onPerioperative HypothermiaSPP-P5.9Ms CHUNGW<strong>in</strong>g-yanAdvancedPractice NurseDepartment of Surgery, Pr<strong>in</strong>ce ofWales HospitalSafe Use of Medical Equipment: To Ensure GoodQuality Service <strong>in</strong> Cl<strong>in</strong>ical WorkplaceSPP-P5.10 Ms HO Joyce AdvancedPractice NurseSPP-P5.11 Dr HUI Aric-josun AssociateConsultantCommunity Outreach ServicesTeam, Alice Ho Miu L<strong>in</strong>gNethersole HospitalDepartment of Medic<strong>in</strong>e, AliceHo Miu L<strong>in</strong>g Nethersole HospitalMedication Safety <strong>Programme</strong> for the Residents at26 Private Residential Care Homes for the Elderly <strong>in</strong>Hong KongDouble Balloon Enteroscopy <strong>in</strong> Hong Kong: Six YearsExperience at a S<strong>in</strong>gle CentreSPP-P5.12 Mr WS KWAN Ward Manager Community Nurs<strong>in</strong>g Service,Pr<strong>in</strong>cess Margaret HospitalA Quality Enhancement <strong>Programme</strong> on NutritionalCare <strong>in</strong> Residential Care Homes for the ElderlySPP-P5.13Ms KWOK Simch<strong>in</strong>gBel<strong>in</strong>daPatient SafetyOfficerQuality and Safety, Coord<strong>in</strong>ator(Cl<strong>in</strong>ical Services) Division, NewTerritories East ClusterEnhance Safe Medication Practices througha Registration Exercise of Non-standardisedDepartment Medication Adm<strong>in</strong>istration RecordsSPP-P5.14 Miss KC KWOK RegisteredNurseDepartment of Medic<strong>in</strong>e andGeriatrics, United ChristianHospitalQuality and Safety Enhancement <strong>Programme</strong> <strong>in</strong> LifeSav<strong>in</strong>g Procedure: Blood TransfusionSPP-P5.15Miss KWOK LukmanResidentPharmacistDepartment of Pharmacy,Kowloon HospitalNear Miss Report<strong>in</strong>g: Time-wast<strong>in</strong>g or Value-added?Experience Shar<strong>in</strong>g from Kowloon Hospital PharmacySPP-P5.16Mr KWONGTsung-hangRegisteredNurseDepartment of Orthopaedicsand Traumatology, Queen MaryHospitalRecurrent Fall Follow<strong>in</strong>g Geriatric Hip Fracture: AProspective Cohort Study of Relationship BetweenCognitive Function and Recurrent Fall <strong>in</strong> GeriatricFractured Hip PatientsSPP-P5.17 Dr LAM May Pharmacist Department of Pharmacologyand Pharmacy, The University ofHong KongEvaluation of Beers and Screen<strong>in</strong>g Tool of OlderPerson’s Prescriptions (STOPP)/Screen<strong>in</strong>g Tool toAlert Doctors to Right Treatment (START) Criteriafor Prescrib<strong>in</strong>g Appropriateness Among Hong KongElderlySPP-P5.18Ms LAM Pui-yeeW<strong>in</strong>nieAdvancedPractice NurseDepartment of Cl<strong>in</strong>ical Oncology,Tuen Mun HospitalA M<strong>in</strong>i Bag is Used for Enhanc<strong>in</strong>g Staff Alertness <strong>in</strong>Drug Allergy CaseSPP-P5.19 Mr LAU Sai-kuk RegisteredNurseDepartment of Medic<strong>in</strong>e andGeriatrics, Tuen Mun HospitalIntroduction of a Compact Alarm<strong>in</strong>g Device toSafeguard Tourniquets
52HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P5 – Quality and Safety <strong>in</strong> Healthcare IILocation Name Post Institution Topic of PresentationSPP-P5.20 Dr LEE Hon-m<strong>in</strong>g AssociateConsultantIntensive Care Unit, Tuen MunHospitalSPP-P5.21 Dr LEE Ka-lok Resident Department of Imag<strong>in</strong>g andInterventional Radiology, Pr<strong>in</strong>ceof Wales HospitalSPP-P5.22 Ms LEE Lai-ha AdvancedPractice NurseCl<strong>in</strong>ical Oncology Department,Queen Elizabeth HospitalAn Evaluation on the Effectiveness of a Goal-directedFeed<strong>in</strong>g Protocol <strong>in</strong> Improv<strong>in</strong>g Calorie Intake ofPatients <strong>in</strong> Intensive Care UnitReduction of Incorrect Identity Incident Dur<strong>in</strong>g MobileRadiography by Us<strong>in</strong>g New 2D Barcode System —Prelim<strong>in</strong>ary ResultA <strong>Programme</strong> to Support Safe Adm<strong>in</strong>istration of OralChemotherapy for Colon Cancer PatientsSPP-P5.23 Ms LEE Yik-mun DepartmentOperationsManagerBlood Collection and DonorRecruitment Department,Hong Kong Red Cross BloodTransfusion ServiceCl<strong>in</strong>ical Waste Reduction <strong>Programme</strong> <strong>in</strong> an ApheresisCollection Centre by Us<strong>in</strong>g Lean Six SigmaMethodologySPP-P5.24Ms LEUNG LaifongTeresaOccupationalTherapist IOccupational TherapyDepartment, Pr<strong>in</strong>ce of WalesHospitalEffectiveness of Computer Assisted Cognitive Tra<strong>in</strong><strong>in</strong>gfor Outpatients with Mild Cognitive Impairment andEarly DementiaSPP-P5.25 Mr LI Hoi-l<strong>in</strong>g RegisteredNurseSPP-P5.26 Dr LUI Chun-tat AssociateConsultantDepartment of Surgery, NorthDistrict HosiptalDepartment of Accident andEmergency, Tuen Mun HospitalEvaluation of Patient Compliance to Pre-operationInstructions(POI) <strong>in</strong> Pre-operation AssessmentCl<strong>in</strong>ic(POAC) for Same Day Admission for Surgery(SDAS) <strong>in</strong> a Surgical Department of a Public HospitalEpidemiology and Outcomes of Out-of-hospitalCardiac Arrest (OHCA): Insights from the First CardiacArrest Registry <strong>in</strong> Hong KongSPP-P5.27 Ms LUI Tsz-chau Ward Manager Community Nurs<strong>in</strong>g Service,Kowloon HospitalSPP-P5.28 Miss MA Yat-man Pharmacist Department of Pharmacy,Pamela Youde NethersoleEastern HospitalFall Prevention <strong>Programme</strong> at Residential Care Homefor the Elderly (RCHE)Design and Implementation of OncologyPharmaceutical Care Service to Enhance MedicationSafety for Oncology PatientsSPP-P5.29 Ms NG Suk-ch<strong>in</strong>g RegisteredNurseSPP-P5.30 Ms NG Wai-mun AdvancedPractice NurseDepatment of Surgery, QueenElizabeth HospitalNurs<strong>in</strong>g Department, CheshireHome, Shat<strong>in</strong>Enhancement <strong>Programme</strong> on Prevention of PatientFallA Structured Pilot Tra<strong>in</strong><strong>in</strong>g <strong>Programme</strong> for Nursesand Cl<strong>in</strong>ical Support<strong>in</strong>g Staff to Prevent SpontaneousBone Fracture <strong>in</strong> the Infirmary Unit at Cheshire HomeShat<strong>in</strong>SPP-P5.31 Ms YB NG Ward Manager Division of Haematologyand Haematology Oncology,Department of Medic<strong>in</strong>e andGeriatrics, United ChristianHospitalEvaluation of Fall Prevention Enhancement<strong>Programme</strong> <strong>in</strong> Haematology UnitSPP-P5.32 Dr SIHOE Alan AssociateConsultantDepartment of CardiothoracicSurgery, Queen Mary HospitalCl<strong>in</strong>ical Pathway for Thoracic Surgery: The InitialExperienceSPP-P5.33Mr SUNG ManhoCharlesPatient SafetyOfficerQuality and Safety Department,North District HospitalIn-depth Analysis of Fall Incident to Focus on QualityImprovementSPP-P5.34Ms TAM MankwanRegisteredNurseOperat<strong>in</strong>g Room, Departmentof Anesthesiology, Pa<strong>in</strong>Management and Operat<strong>in</strong>gService, United ChristianHospitalSmart Conta<strong>in</strong>er — Safer Handl<strong>in</strong>g of Dis<strong>in</strong>fectantSolutionSPP-P5.35 Dr HO Yau-leung AssociateConsultantDepartment of Anaesthesiaand Intensive Care, Tuen MunHospitalPromotion of Pa<strong>in</strong> as Fifth Vital Sign andImplementation of Pa<strong>in</strong> Management ProtocolsImprove Post-operative Pa<strong>in</strong> Management <strong>in</strong> TuenMun HospitalSPP-P5.36Ms WAN Lai-yiSel<strong>in</strong>aSeniorOccupationalTherapistOccupational TherapyDepartment, Kwong WahHospitalEffectiveness of Bowen Therapy Practiced byOccupational Therapist <strong>in</strong> Improv<strong>in</strong>g Physical Functionand Activities of Daily Liv<strong>in</strong>g of People with ShoulderStiffness (Frozen Shoulder)
Poster PresentationsSPP-P5 – Quality and Safety <strong>in</strong> Healthcare IIService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P5.37 Dr WONG Amy AssociateConsultantSPP-P5.38 Mr WONG Sunny AdvancedPractice NurseSPP-P5.39Miss WONG Y<strong>in</strong>l<strong>in</strong>gWard ManagerDepartment of Ophthalmology,Caritas Medical CentreWorkgroup of Pressure UlcerPrevention and Management,Tseung Kwan O HospitalDepartment of Ophthalmologyand Visual Sciences, NewTerritories East ClusterIntraocular Lens Power Measurement StandardisationProjectEmpowerment of Health/Patient Care Assistants(HCA/PCAs): Validat<strong>in</strong>g Their Important Role <strong>in</strong>Pressure Ulcer Prevention and Sk<strong>in</strong> Care <strong>in</strong> AcuteGeneral WardsAn Impossible Mission? Application of Medicationand Adm<strong>in</strong>istration Record (MAR) <strong>in</strong> High VolumeOutpatient Eye Cl<strong>in</strong>ic Sett<strong>in</strong>g53HOSPITAL AUTHORITY CONVENTION 2013SPP-P5.40 Ms YIU Sau-chi AdvancedPractice NurseCardiac Care Unit, MedicalDepartment, North DistrictHospitalZero Infection on Cardiac Implantable ElectronicDevice (CIED) Patients
54HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P6 – Susta<strong>in</strong>able WorkforceLocation Name Post Institution Topic of PresentationSPP-P6.1 Dr AU Shek-y<strong>in</strong> Resident Intensive Care Unit, QueenElizabeth HospitalSPP-P6.2 Mr WONG John Trauma NurseCoord<strong>in</strong>atorSPP-P6.3Dr CHAN ChunkongResidentSpecialistAccident and EmergencyDepartment, Tuen Mun HospitalDepartment of Medic<strong>in</strong>e andGeriatrics, United ChristianHospitalBasic Adult Mechanical Ventilator Simulation Tra<strong>in</strong><strong>in</strong>gfor Doctors <strong>in</strong> Kowloon Central ClusterDevelop Competency-based Assessment Tool forEmergency Nurses to Ensure Safe Patient Cares <strong>in</strong> aCluster Emergency Department <strong>in</strong> Hong KongReduction <strong>in</strong> Disease Disability by Early Delivery ofIntravenous Thrombolysis <strong>in</strong> Acute Ischemic Stroke:An Evaluation of Treatment Safety and Cl<strong>in</strong>icalOutcomesSPP-P6.4 Mr CHAN Ka-lun SeniorPhysiotherapistPhysiotherapy Department,Haven of Hope HospitalStaff Fall Prevention <strong>Programme</strong>SPP-P6.5Dr CHAN Tuench<strong>in</strong>gResidentSpecialistDepartment of Medic<strong>in</strong>e andGeriatrics, TWGHs Fung Yiu K<strong>in</strong>gHospitalA Susta<strong>in</strong>able Rehabilitation <strong>Programme</strong> Us<strong>in</strong>gInteractive Virtual Reality Wii with Help of SecondarySchool Student VolunteersSPP-P6.6Miss CHAN YeechiAdvancedPractice NurseNurs<strong>in</strong>g Services Division,Ruttonjee and Tang Shiu K<strong>in</strong>HospitalsStepped Staff Development for Nurses of the NextGenerationSPP-P6.7Mr CHAN Yukw<strong>in</strong>gNurse SpecialistAccident and EmergencyDepartment, Tuen Mun HospitalFirst Year Journey of New Graduated EmergencyNurse-life <strong>in</strong> Tuen Mun Hospital Accident andEmergency DepartmentSPP-P6.8 Ms KARN K<strong>in</strong>-yi AdvancedPractice NurseSPP-P6.9 Mr CY CHEUNG OccupationalSafety andHealth OfficerCommunity Nurs<strong>in</strong>g Service,United Christian HospitalOccupational Safety and HealthTeam, Kowloon East ClusterNew Model of Nurs<strong>in</strong>g Cl<strong>in</strong>ical HandoverSusta<strong>in</strong>able Improvement <strong>in</strong> Occupational Safetyand Health (OSH) by Implementation of SafetyManagement SystemSPP-P6.10Ms CHEUNGShuk-yeeAdvancedPractice NurseMedic<strong>in</strong>e and GeriatricsDepartment, Shat<strong>in</strong> HospitalPatient Care Assistant (PCA) Retention <strong>Programme</strong> <strong>in</strong>a Unit of Convalescent HospitalSPP-P6.11 Ms CHU S<strong>in</strong>-yee SeniorRadiographerSPP-P6.12 Dr HUI Aric-josun AssociateConsultantSPP-P6.13 Mr HUI Tze-shau AdvancedPractice NurseSPP-P6.14 Ms IP Shani RegisteredNurseDepartment of Radiology andNuclear Medic<strong>in</strong>e, Tuen MunHospitalDepartment of Medic<strong>in</strong>e, AliceHo Miu L<strong>in</strong>g Nethersole HospitalCentral Nurs<strong>in</strong>g Department, OurLady of Maryknoll HospitalDepartment of Medic<strong>in</strong>e, YanChai HospitalAutomatic Fil<strong>in</strong>g of Job Sheet for Medical EquipmentComparison of Colonoscopic Performance BetweenMedical and Nurse Endoscopists: A RandomisedControlled Study <strong>in</strong> AsiaOccupational Safety and Health (OSH) <strong>Programme</strong> —Red Dots Mobility SystemEnhance Stroke Knowledge Among Nurses toIncrease the Competence and Confidence <strong>in</strong>Provid<strong>in</strong>g Nurs<strong>in</strong>g Care for Stroke PatientsSPP-P6.15Ms KWONG SofongConsultantPhysiotherapistPhysiotherapy Department,Hong Kong East ClusterFirst Year Experience: Development of aComprehensive Six-week Work-based Tra<strong>in</strong><strong>in</strong>g<strong>Programme</strong> for Physiotherapists <strong>in</strong> Hong Kong EastClusterSPP-P6.16Ms LAM Pui-yeeW<strong>in</strong>nieAdvancedPractice NurseDepartment of Cl<strong>in</strong>ical Oncology,Tuen Mun HospitalTo Susta<strong>in</strong> the Safe Practice and Nurs<strong>in</strong>g Care <strong>in</strong>Oncology WardSPP-P6.17Mr LEE ChunkeungAdvancedPractice NurseOperat<strong>in</strong>g Theatre, Departmentof Anaesthesia and IntensiveCare Unit, Pr<strong>in</strong>ce of WalesHospitalTo Rule Out the Better Tra<strong>in</strong><strong>in</strong>g Strategy Amonga Large Department via a Research: "To Evaluatethe Effect of Video Education on Staff KnowledgeTowards Prone Position<strong>in</strong>g <strong>in</strong> Operation Theatre"SPP-P6.18 Dr LEE Fu-tat Consultant Accident and EmergencyDepartment, Pr<strong>in</strong>cess MargaretHospitalSimulation Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Multi-discipl<strong>in</strong>ary Care of MajorTrauma PatientsSPP-P6.19 Dr LEE Ka-yee AssociateConsultantDepartment of Anaesthesiologyand Operat<strong>in</strong>g Services, NorthDistrict HospitalInsomnia and Drug-seek<strong>in</strong>g Behaviour AmongAnaesthesiologists <strong>in</strong> Hong Kong
Poster PresentationsSPP-P6 – Susta<strong>in</strong>able WorkforceService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P6.20 Ms WM LEE AdvancedPractice NurseSPP-P6.21SPP-P6.22Mr LEUNG LokmanMr LEUNG M<strong>in</strong>ghungAdvancedPractice NurseAdvancedPractice NurseInfection Control Team, Pr<strong>in</strong>cessMargaret HospitalWard 13A, Isolation Ward,Department of Medic<strong>in</strong>e andGeriatrics, United ChristianHospitalCentral Nurs<strong>in</strong>g Division, Pr<strong>in</strong>ceof Wales HospitalEnhanced Hospital Hygienic Monitor<strong>in</strong>g <strong>Programme</strong>2011-2012Tra<strong>in</strong><strong>in</strong>g for Patient Care Assistants <strong>in</strong> an IsolationWard — to Increase Occupational Safety and HealthAwarenessVacc<strong>in</strong>ation-on-wheel (VOW) <strong>Programme</strong>55HOSPITAL AUTHORITY CONVENTION 2013SPP-P6.23Ms LEUNG LaifongTeresaOccupationalTherapist IOccupational TherapyDepartment, Pr<strong>in</strong>ce of WalesHospitalA Review on Work-based Tra<strong>in</strong><strong>in</strong>g for OccupationalTherapy Staff <strong>in</strong> New Territories East ClusterSPP-P6.24Ms LEUNG YukkwanJulianaHospitalAdm<strong>in</strong>istrator ISupport<strong>in</strong>g Services Department,Kwong Wah HospitalDevelopment of the Optimal Staff CommunicationModel at Kwong Wah HospitalSPP-P6.25 Ms LI Ka-y<strong>in</strong>g RegisteredNurseCommunity Nurs<strong>in</strong>g Service,Pr<strong>in</strong>cess Margaret HospitalEvidence-based Practice: Sharp Debridement <strong>in</strong>Wound CareSPP-P6.26Dr MOK ChunkeungChief of ServiceDepartment of Medic<strong>in</strong>e andGeriatrics, Tuen Mun HospitalEvaluation of Medical Staff Feedback on Us<strong>in</strong>gUpToDate® as a Departmental Web-based Po<strong>in</strong>t-ofcareConsultation Support for Medic<strong>in</strong>e and GeriatricsDepartment, New Territories West ClusterSPP-P6.27Miss PANG W<strong>in</strong>gkamHospitalAdm<strong>in</strong>istrator IISupport<strong>in</strong>g Services Department,Pr<strong>in</strong>cess Margaret HospitalCont<strong>in</strong>ue Quality Improvement: To ReduceUnnecessary Ad-hoc Requests Made by Wards onL<strong>in</strong>en SupplySPP-P6.28 Dr PON Wai-pi Resident Department of Family Medic<strong>in</strong>eand Primary Healthcare, CaritasMedical CentrePrevalence and Associated Factors of Burnout AmongDoctors Work<strong>in</strong>g <strong>in</strong> Public General Outpatient Cl<strong>in</strong>ic(GOPC) <strong>in</strong> Kowloon West Cluster of Hong KongSPP-P6.29Miss POON WaiyeeMargaretSeniorPhysiotherapistPhysiotherapy Department,Queen Elizabeth HospitalWork-<strong>in</strong>jured staff: Physiotherapy Rehabilitation<strong>Programme</strong>SPP-P6.30Ms WONG y<strong>in</strong>l<strong>in</strong>gWard ManagerSpecialist OutpatientDepartment, United ChristianHospitalAn Information Technology (IT) System to Enhance theWorkflow of Us<strong>in</strong>g Octopus Enabled Self-registrationKiosk <strong>in</strong> Specialist Outpatient Departments (SOPDs)SPP-P6.31Ms TAM YuenyeeAdvancedPractice NurseDepartment of Cl<strong>in</strong>ical Oncology,Tuen Mun HospitalOccupational Safety and Health (OSH) Enhancement<strong>Programme</strong> on Precaution on Chemotherapy DrugHandl<strong>in</strong>gSPP-P6.32Mr WONG KenchiOccupationalTherapist IOccupational Medic<strong>in</strong>e CareService, New Territories EastClusterA N<strong>in</strong>e Year Return to Work Journey — fromDesperation to MotivationSPP-P6.33 Mr SY WONG System Analyst Information TechnologyDepartment, United ChristianHospitalYou See Channel/T — a New and Effective Way toDeliver Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Hospital AuthoritySPP-P6.34Dr WONG W<strong>in</strong>gnamSenior HealthInformatician(eHR) SpecialDutiesF<strong>in</strong>ance Division, HospitalAuthority Head OfficeLocal Insights <strong>in</strong>to the Myth of Us<strong>in</strong>g CasemixInformation for Manpower Plann<strong>in</strong>gSPP-P6.35Mr LEUNG TakfaiAdvancedPractice NurseOperat<strong>in</strong>g Room, Departmentof Anaesthesiology, Pa<strong>in</strong>Management and Operat<strong>in</strong>gService, United ChristianHospital2012 Kowloon East Cluster Occupational Safety andHealth (Manual Handl<strong>in</strong>g Operation) ImprovementProject Award — Gold Award: Jolly Cart — theRevolution of Distilled Water Bottle TransportationSPP-P6.36Miss WONG Y<strong>in</strong>l<strong>in</strong>gWard ManagerDepartment of Ophthalmologyand Visual Sciences, NewTerritories East ClusterWorkplace Safety Improvement: Invention of NewMedical Record Mobile Cab<strong>in</strong>et <strong>in</strong> High VolumeOutpatient Eye Cl<strong>in</strong>ic Sett<strong>in</strong>gSPP-P6.37Ms YANG SzemanWard ManagerThe Department ofAnaesthesiology and Operat<strong>in</strong>gTheatre Services, Kwong WahHospitalMyth or Reality for Us<strong>in</strong>g Apps to Manage Duty Rosterof Nurs<strong>in</strong>g Staff
56HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P6 – Susta<strong>in</strong>able WorkforceLocation Name Post Institution Topic of PresentationSPP-P6.38 Dr LM YAU Resident Department of Family Medic<strong>in</strong>eand Primary Health Care, UnitedChristian HospitalSPP-P6.39SPP-P6.40Ms YEUNG Yuetm<strong>in</strong>gMs YUEN Miuch<strong>in</strong>gCheriAdvancedPractice NurseOccupationalTherapist IIDepartment of Surgery, QueenElizabeth HospitalOccupational TherapyDepartment, Castle PeakHospitalPrevalence and Characteristic of Staff Attend<strong>in</strong>ga Hospital Authority Staff Cl<strong>in</strong>ic Presented withPsychological ProblemsEnhanc<strong>in</strong>g Staff Competency <strong>in</strong> Breast Care Nurs<strong>in</strong>gThe Cl<strong>in</strong>ical Outcomes of the Handwrit<strong>in</strong>g SkillTra<strong>in</strong><strong>in</strong>g Group: A Pre- and Post- Study
Poster PresentationsSPP-P7 – Modernisation of HealthcareService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P7.1 Ms CHAN Kit-nga RegisteredNurseSPP-P7.2 Dr CHAN Laam AssociateConsultantSPP-P7.3Dr CHAN TszmimJasm<strong>in</strong>eAssociateConsultantDepartment of Medic<strong>in</strong>e andGeriatrics, United ChristianHospitalDepartment of Family Medic<strong>in</strong>eand Primary Health Care, NewTerritories West ClusterPalliative Care Unit, Departmentof Medic<strong>in</strong>e and Geriatrics, OurLady of Maryknoll HospitalImplications of an Intensive Case Management Modelfor the Post Discharge High Risk Elderly with HeartFailureImprov<strong>in</strong>g Mental Healthcare through CollaborativeApproach <strong>in</strong> Primary Care: A Three Years Cohort DataCare of the Dy<strong>in</strong>g: End-of-life Care Pathway <strong>in</strong>Palliative Care Unit57HOSPITAL AUTHORITY CONVENTION 2013SPP-P7.4Mr CHEE SweehawBryanPhysiotherapistIIPhysiotherapy Department,Queen Elizabeth HospitalEffects of Robot-assisted Arm Tra<strong>in</strong><strong>in</strong>g for Promot<strong>in</strong>gMotor Recovery <strong>in</strong> Patients After StrokeSPP-P7.5Dr CHEUNG Waiy<strong>in</strong>ResidentSpecialistPalliative Care Team, UnitedChristian HospitalEarly Experiences at United Christian Hospital <strong>in</strong>Advance Directives Refus<strong>in</strong>g CardiopulmonaryResuscitationSPP-P7.6 Dr CHOW Yat AssociateConsultantPsychiatry Department, KwaiChung HospitalA Community Mental Health Call Centre to StrengthenSupport to Psychiatric Patients and Caregivers <strong>in</strong> theCommunitySPP-P7.7Ms CHU ChuiyeeAdvancedPractice NurseBlood Collection and DonorRecruitment Department,Hong Kong Red Cross BloodTransfusion ServiceBlood Donation Ambassador <strong>Programme</strong>: Integrationof Donor Recruitment and Retention Activities throughCommunity Partnerships — an Interim ReportSPP-P7.8Ms FONG WaiyeeWendyAdvancedPractice NurseOperation Theatre/Central SterileSupplies Department, HongKong Baptist HospitalModern Central Sterile Supplies Department (CSSD)— Pioneer Application of ISO 9001/13485SPP-P7.9Miss LAI ChikwanRegisteredNurseAccident and EmergencyDepartment, United ChristianHospitalEvaluat<strong>in</strong>g Performance of Nurse-led M<strong>in</strong>or InjuryManagement Service <strong>in</strong> the Emergency Department:A Randomised Controlled TrialSPP-P7.10Dr WONGEdmondAssociateConsultantDepartment of Medic<strong>in</strong>e andGeriatrics, Pok Oi HospitalConventional Coronary Angiogram vs HybridRotational Coronary AngiogramSPP-P7.11 Mr LAM Wa-s<strong>in</strong>g RegisteredNurseGeriatrics Unit, Department ofMedic<strong>in</strong>e and Geriatrics, UnitedChristian Hospital1+1=30 Half Hourly Ward Round at NightSPP-P7.12Miss LAM YuenhaRitaPhysiotherapistIPhysiotherapy Department,Queen Mary HospitalFast-track Discharge <strong>Programme</strong> of Primary TotalJo<strong>in</strong>t Replacement <strong>in</strong> Queen Mary HospitalSPP-P7.13Dr LAU Mo-yeePollyCluster ManagerPhysiotherapy Department,Queen Elizabeth HospitalEffectiveness of Underwater Gymnasium <strong>Programme</strong>for Patients with Osteoarthritic Knee ConditionSPP-P7.14 Ms LEE Grace SeniorOccupationalTherapistSPP-P7.15 Ms SP LEE ClusterDepartmentManagerOccupational TherapyDepartment, Kwai ChungHospitalDepartment of Dietetics, UnitedChristian HospitalA Computerised Errorless Learn<strong>in</strong>g-based MemoryTra<strong>in</strong><strong>in</strong>g <strong>Programme</strong> for Early Alzheimer’s DiseaseCh<strong>in</strong>ese Patients: A Pilot StudyMeasured Metabolic Requirement for Septic ShockPatients Before and After Liberation from MechanicalVentilationSPP-P7.16Mr LEUNG ChikwongRegisteredNurseIntensive Care Unit, North DistrictHospitalThe Implementation of Innovative Technology <strong>in</strong>Intensive Care Unit for Enhanc<strong>in</strong>g Communication andEducation with Critically Ill Patient’s Family MembersSPP-P7.17 Dr LI Yuen-mei ResidentSpecialistSPP-P7.18 Dr WAN Peter HealthInformaticianSPP-P7.19 Dr LUI Chun-tat AssociateConsultantHong Kong Eye HospitalInformation TechnologyServices, Hospital AuthorityHead OfficeDepartment of Accident andEmergency, Tuen Mun HospitalIntroduction of Punch Biopsy Service at the HongKong Eye HospitalImprov<strong>in</strong>g ePR View<strong>in</strong>g EfficiencyComputerisation of Frontl<strong>in</strong>e Physicians’ ClericalWork, Medical Documentation and MedicationPrescription Dur<strong>in</strong>g Patient Admission — the eAdmitProject
58HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P7 – Modernisation of HealthcareLocation Name Post Institution Topic of PresentationSPP-P7.20Mr LUI Ka-lokGilbertWard ManagerSPP-P7.21 Dr LUK Lai-y<strong>in</strong> AssociateConsultantSPP-P7.22Dr MAK Hoi-kwanCalv<strong>in</strong>ResidentDepartment of Surgery, PamelaYoude Nethersole EasternHospitalDepartment of Surgery, QueenElizabeth HospitalDivision of Neurosurgery,Department of Surgery, Pr<strong>in</strong>ce ofWales HospitalNurse-led Extracorporeal Shock Wave Therapy forChronic Pelvic Pa<strong>in</strong> SyndromeNew Paradigm <strong>in</strong> Management of Huge Large BowelPolyps — Queen Elizabeth Hospital Experience ofColorectal Endoscopic Submucosal DissectionEfficacy and Safety of Intrathecal Baclofen PumpSPP-P7.23 Dr NG Lorna Senior MedicalOfficerFamily Medic<strong>in</strong>e and GeneralOutpatient Department, KwongWah HospitalAcceptance and Barriers on the Use of ElectronicHealth (eHealth) or Mobile Health (mHealth) AmongHypertensive Patients <strong>in</strong> Primary Care Sett<strong>in</strong>g: CrossSectional Questionnaire StudySPP-P7.24Dr POON KamshanAssociateConsultantDepartment of Psychiatry, TuenMun HospitalA New Paradigm of Consultation Liaison Service:Experience of the Psycho-oncology Cl<strong>in</strong>ic <strong>in</strong> the NewTerritories West ClusterSPP-P7.25MsSAMARANAYAKNithushiPhD CandidateDepartment of Medic<strong>in</strong>e, TheUniversity of Hong KongImplement<strong>in</strong>g a Stand-alone Bar-code AssistedMedication Adm<strong>in</strong>istration System: Effects on theDispens<strong>in</strong>g Process and User PerceptionsSPP-P7.26Ms SHUM NgaFanAdvancedPractice NurseDepartment of Surgery, QueenMary HospitalTranslat<strong>in</strong>g Western Learn<strong>in</strong>g <strong>in</strong>to Practice:Biofeedback Therapy for Bowel Dysfunctional PatientsSPP-P7.27Mr SHUM Waich<strong>in</strong>gNurseConsultantDepartment of Medic<strong>in</strong>e andTherapeutics, Pr<strong>in</strong>ce of WalesHospitalExpand<strong>in</strong>g Nurse’s Roles and Strengthen Cl<strong>in</strong>icalCollaboration to Accomplish Cluster-based 24 hoursThrombolysis Services <strong>in</strong> New Territories East ClusterSPP-P7.28 Dr SIHOE Alan AssociateConsultantDepartment of CardiothoracicSurgery, Queen Mary HospitalImprov<strong>in</strong>g Outcomes <strong>in</strong> Thoracic Surgery withPortable Digital Chest Dra<strong>in</strong>age TechnologySPP-P7.29Dr SIU Wei-manBonnieAssociateConsultantDepartment of Hospital ChiefExecutive, Chief of Services andCl<strong>in</strong>ical Services, Castle PeakHospitalApplication of Mobile Technology to Enhance StressManagement and the Early Intervention of StressrelatedMental Health Problems <strong>in</strong> the CommunitySPP-P7.30Mr TANG TakhungPeterPhysiotherapistIPhysiotherapy Department,Castle Peak HospitalAn Innovative Approach by Us<strong>in</strong>g Acupuncture forImprov<strong>in</strong>g the Ur<strong>in</strong>ary Symptoms of Patients withKetam<strong>in</strong>e DependenceSPP-P7.31Dr TANG W<strong>in</strong>gszeMariaAssociateConsultantIntegrated Care and DischargeSupport Service for ElderlyPatients, Pr<strong>in</strong>ce of WalesHospitalUse of iPad to Facilitate Discharge Plann<strong>in</strong>g of HighRisk Elderly PatientsSPP-P7.32Dr WONG Kwaiw<strong>in</strong>gAssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care, UnitedChristian HospitalEnhanc<strong>in</strong>g the Management of Hypertension byFamily Physician-led Hypertension Cl<strong>in</strong>ics <strong>in</strong> KowloonEast Cluster General Outpatient Cl<strong>in</strong>icsSPP-P7.33Ms WONG KacheeAdvancedPractice NurseDepartment of Medic<strong>in</strong>e, QueenMary HospitalImprov<strong>in</strong>g Glycaemic Control <strong>in</strong> the Managementof Diabetes — the Role of Cont<strong>in</strong>uous GlucoseMonitor<strong>in</strong>g <strong>in</strong> Diabetes Nurse Cl<strong>in</strong>icSPP-P7.34Dr WONG K<strong>in</strong>gy<strong>in</strong>gAssociateConsultantDepartment of Tuberculosis andChest, TWGHs Wong Tai S<strong>in</strong>HospitalIntegrated Use of Virtual Bronchoscopy andEndobronchial Utlrasonography <strong>in</strong> BronchoscopicDiagnosis of Peripheral Lung LesionsSPP-P7.35Ms WONG KitmanRegisteredNurseDepartment of Medic<strong>in</strong>e, PamelaYoude Nethersole EasternHospitalA Pilot Community-based Pulmonary Rehabilitation<strong>Programme</strong> <strong>in</strong> Hong Kong East ClusterSPP-P7.36 Mr WONG Sunny AdvancedPractice NurseNurs<strong>in</strong>g Service Division, TseungKwan O HospitalImprovement Project of Wound Care Nurs<strong>in</strong>gService by Provision of Lymphoedema Managementfor Patients with Related Lower Limb Ulcers (PilotScheme <strong>in</strong> Tseung Kwan O Hospital and CaritasMedical Centre)
Poster PresentationsSPP-P7 – Modernisation of HealthcareService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P7.37SPP-P7.38Ms WONG W<strong>in</strong>gyeeMs WOO Chuip<strong>in</strong>gAdvancedPractice NurseAdvancedPractice NurseDepartment of Orthopaedics andTraumatology, Queen ElizabethHospitalDepartment of Old AgePsychiatry, Castle Peak HospitalSPP-P7.39 Dr YAU Anthony Resident Department of Medic<strong>in</strong>e andGeriatrics, Caritas MedicalCentreA Large Sample Prospective Study on AmbulatoryPrognosis Predictive Factors for Geriatric Hip FractureThe First Mobile Multi-sensory Stimulation Therapyfor Psychogeriatric Inpatients <strong>in</strong> Hong KongThe Use of Convex Probe EndobronchialUltrasonography (EBUS) <strong>in</strong> Diagnos<strong>in</strong>g LungPathology59HOSPITAL AUTHORITY CONVENTION 2013SPP-P7.40 Ms TH YIP AdvancedPractice NurseCommunity Nurs<strong>in</strong>g Service,Pr<strong>in</strong>cess Margaret Hospital“PEACE” <strong>Programme</strong>: To Promote Quality of Dy<strong>in</strong>g forFrail Elders
60HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P8 – Young HA Investigators PresentationsLocation Name Post Institution Topic of PresentationSPP-P8.1SPP-P8.2SPP-P8.3Mr CHAN ChunkitJackyDr CHAN HoiwongDr CHAN SzewunW<strong>in</strong>nieRegisteredNurseAssociateConsultantAssociateConsultantAccident and Emergency Tra<strong>in</strong><strong>in</strong>gCentre, Tang Shiu K<strong>in</strong> HospitalRenal Unit, Department ofMedic<strong>in</strong>e, Queen ElizabethHospitalDepartment of Radiology andImag<strong>in</strong>g, Queen ElizabethHospitalCasualty Simulation for Trauma Courses <strong>in</strong> HongKongCost Effectiveness of Erythropoiesis Stimulat<strong>in</strong>gAgents <strong>in</strong> End Stage Renal Disease Patients onPalliative Care — a S<strong>in</strong>gle Centre PerspectiveLogistic Pathways of Super Early ComputedTomography Coronary Angiogram for Patients withSuspected Acute Coronary SyndromeSPP-P8.4Dr CHAN Y<strong>in</strong>hangAssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care, NewTerritories West ClusterIntegrated Mental Health <strong>Programme</strong> (IMHP), aStructured Primary Care Mental Health <strong>Programme</strong>,Experience <strong>in</strong> T<strong>in</strong> Shui WaiSPP-P8.5Dr CHAN YuenyanAssociateConsultantFamily Medic<strong>in</strong>e Department,Pr<strong>in</strong>ce of Wales HospitalJob Satisfaction, Stress and Mental Wellbe<strong>in</strong>g ofHealthcare Workers <strong>in</strong> a Regional Public HospitalSPP-P8.6Dr CHEN Xiao-ruiCather<strong>in</strong>eAssociateConsultantDepartment of Family Medic<strong>in</strong>eand General Outpatient Cl<strong>in</strong>ic,Kowloon Central ClusterSecondary Prevention of Stroke: Knowledge andPerception of Stroke Risk Factors Among PrimaryCare Hong Kong Ch<strong>in</strong>ese Patients with PreviousHistory of Stroke or Transient Ischemic Attack (TIA)SPP-P8.7Dr CHEN Xiao-ruiCather<strong>in</strong>eAssociateConsultantDepartment of Family Medic<strong>in</strong>eand General Outpatient Cl<strong>in</strong>ic,Kowloon Central ClusterAnaemia and Type 2 Diabetes: Implications from aRetrospective Case Series Study <strong>in</strong> Primary CareSPP-P8.8 Ms KP CHENG AdvancedPractice NurseQuality and Safety Division,United Christian HospitalWhatsApp Quality and Safety Related Alert: StayConnected with InternsSPP-P8.9Dr CHIANG ChileungResidentSpecialistDepartment of Cl<strong>in</strong>ical Oncology,Tuen Mun HospitalManage Patients with Malignant Pleural Effusion (MPE)Us<strong>in</strong>g Indwell<strong>in</strong>g Pleural Catheter (IPC) for IntermittentDra<strong>in</strong>age at Outpatient Sett<strong>in</strong>g: A Safe and CostEffective ApproachSPP-P8.10Dr CHIANG Lapk<strong>in</strong>ResidentFamily Medic<strong>in</strong>e and GeneralOutpatient Department, KwongWah HospitalWhite-coat Hypertension and White-coatPhenomenon <strong>in</strong> Primary Care Sett<strong>in</strong>g: RetrospectiveReview of Ambulatory Blood Pressure Monitor<strong>in</strong>g(ABPM)SPP-P8.11 Dr LAM K<strong>in</strong>-man Consultant Department of Surgery, TseungKwan O HospitalPeri-prostatic Nerve Block is Safe and Effective asDay Procedure for Prostate BiopsySPP-P8.12 Dr CHU Tsun-kit ResidentSpecialistYuen Long Community CareCentre, Department of FamilyMedic<strong>in</strong>e and Primary HealthCare, New Territories WestClusterEnhanc<strong>in</strong>g Service Delivery <strong>in</strong> Primary Care byMedical Triage Cl<strong>in</strong>icSPP-P8.13Ms FONGKathrynAdvancedPractice NurseDepartment of Ambulatory Care,Caritas Medical CentreHigher Diploma Nurs<strong>in</strong>g Students’ Satisfaction andSelf-confidence with High-fidelity SimulationSPP-P8.14 Mr LAM Way HospitalAdm<strong>in</strong>istrator IIFacility ManagementDepartment, Pr<strong>in</strong>cess MargaretHospitalEnergy Sav<strong>in</strong>g <strong>in</strong> Pr<strong>in</strong>cess Margaret HospitalSPP-P8.15Dr FUNG TaihangThomasResidentSpecialistDepartment of Ear Nose andThroat, Pamela Youde NethersoleEastern HospitalA Prospective Study on the Efficacy of TopicalMitomyc<strong>in</strong> C as an Adjuvant Treatment <strong>in</strong> P<strong>in</strong>na KeloidSPP-P8.16Dr HUI Yun-yeeEnconHospitalManagerFacility Management Department,Kwong Wah HospitalStrategy of Manag<strong>in</strong>g Water Quailty <strong>in</strong> Exist<strong>in</strong>gHospitalSPP-P8.17 Dr KAM M<strong>in</strong>g-ho Resident Department of Surgery, QueenElizabeth HospitalOutcomes of Major Surgery <strong>in</strong> Patients Above 85Years OldSPP-P8.18 Dr LI Heung-w<strong>in</strong>g AssociateConsultantSPP-P8.19 Dr KWAN Hoi-yee ResidentSpecialistDepartment of Family Medic<strong>in</strong>e,New Territories East ClusterDepartment of Medic<strong>in</strong>e, NorthDistrict HospitalBr<strong>in</strong>g<strong>in</strong>g Old to New and Improv<strong>in</strong>g Primary CareManagement: Primary Care Musculoskeletal (MSK)Cl<strong>in</strong>icsOrganisation of Care for Chronic ObstructivePulmonary Disease Patients Receiv<strong>in</strong>g Non-<strong>in</strong>vasiveVentilation <strong>in</strong> Public Hospitals of Hong Kong
Poster PresentationsSPP-P8 – Young HA Investigators PresentationsService Priorities and <strong>Programme</strong>sLocation Name Post Institution Topic of PresentationSPP-P8.20SPP-P8.21Dr KWOK Wait<strong>in</strong>gDr LAI Suk-yiIreneResidentAssociateConsultantSPP-P8.22 Dr SIN Rutherford ResidentSpecialistDivision of CardiothoracicSurgery, Pr<strong>in</strong>ce of Wales HospitalDepartment of Family Medic<strong>in</strong>eand Primary Health Care, HongKong East ClusterTuen Mun HospitalBlood Transfusion <strong>in</strong> Intensive Care Unit Follow<strong>in</strong>gCardiac Surgery: Susta<strong>in</strong>able Improvements Us<strong>in</strong>gReal Time Monitor<strong>in</strong>gThe Effectiveness of Comb<strong>in</strong>ed Nicot<strong>in</strong>e ReplacementTherapy for Smok<strong>in</strong>g CessationLow Frame Rate (7.5 Frames per Second) Radiationfor Coronary Angiogram and Percutaneous CoronaryIntervention (PCI) by Philips Allura Xeper FD1061HOSPITAL AUTHORITY CONVENTION 2013SPP-P8.23 Dr LAM S<strong>in</strong>-man AssociateConsultantDepartment of Intensive Care,Pamela Youde NethersoleEastern HospitalIntensive Care Unit Family Satisfaction SurveySPP-P8.24Ms LAU M<strong>in</strong>gm<strong>in</strong>gAdvancedPractice NurseDay Centre, CardiothoracicSurgery Department, QueenMary HospitalNurse-led Cl<strong>in</strong>ic <strong>in</strong> Re-eng<strong>in</strong>eer<strong>in</strong>g of Pre-operativeAssessment to Shorten Wait<strong>in</strong>g Time for EarlyCoronary Artery Bypass Graft Surgery (CABG) andBuild Partnership with PatientsSPP-P8.25 Dr LEE Man-h<strong>in</strong> Resident Department of Obstetrics andGynaecology, Queen ElizabethHospitalIncidence, Causes, Complications and TrendsAssociated with Peripartum Hysterectomy andInterventional Management for Post PartumHaemorrhage – a 14 Year Study.SPP-P8.26Mr LEE y<strong>in</strong>-takKenPhysiotherapistIDepartment of Physiotherapy,Tuen Mun HospitalSitt<strong>in</strong>g Tai Chi: A Novel Evidence-based ExerciseRegime for Frail ElderlySPP-P8.27 Ms LO Ela<strong>in</strong>e Pharmacist Department of Pharmacy, KwongWah HospitalEffective Utilisation of Resources throughIdentification of High Risk Patient Groups <strong>in</strong>Pharmacist-run Medication Reconciliation ServiceSPP-P8.28 Ms MAK Lai-see RegisteredNurseAcute Geriatric Unit, GranthamHospitalWard-Based Cont<strong>in</strong>ence <strong>Programme</strong> to Ma<strong>in</strong>ta<strong>in</strong>Cont<strong>in</strong>ence for Hospitalised Older PatientsSPP-P8.29Ms MAN CheukleeCherryHospitalManagerAdm<strong>in</strong>istrative ServicesDepartment, Castle PeakHospitalGreen Castle Peak Hospital Goes GreenerSPP-P8.30Miss NGAI Meip<strong>in</strong>gPhysiotherapistIIPhysiotherapy Department, FungYiu K<strong>in</strong>g HospitalEnhanced Physiotherapy Service of Post-dischargeSupport for Geriatric Patients with Hip Fracture Liv<strong>in</strong>g<strong>in</strong> Private Old Aged Home (POAH)SPP-P8.31Dr TANG W<strong>in</strong>gkayVictoriaAssociateConsultantDepartment of General AdultPsychiatry, Castle Peak HospitalImpact of Patient Art on Public Attitude TowardsMental IllnessSPP-P8.32 Dr TSE Hoi-nam ResidentSpecialistMedic<strong>in</strong>e and GeriatricsDepartment, Kwong WahHospitalHigh-Dose N-Acetylcyste<strong>in</strong>e <strong>in</strong> Stable ChronicObstructive Pulmonary Disease (COPD): The Oneyear,Double-bl<strong>in</strong>d, Randomised, Placebo-controlledHIACE StudySPP-P8.33 Dr TSOI Kelv<strong>in</strong> Statistician Statistics and WorkforcePlann<strong>in</strong>g Department, Strategyand Plann<strong>in</strong>g Division, HospitalAuthority Head OfficeService Evaluation for Diabetic Patients <strong>in</strong> PatientSupport Call Centre: Knowledge and Practice AnalysisSPP-P8.34 Dr TK WONG AssociateConsultantDepartment of Family Medic<strong>in</strong>eand Primary Health Care, UnitedChristian HospitalEffectiveness of Counsel<strong>in</strong>g by Primary CarePhysicians <strong>in</strong> Promot<strong>in</strong>g Cervical Cancer Screen<strong>in</strong>gAmong Middle-aged Women — a RandomisedControlled StudySPP-P8.35 Mr WONG Errol Pharmacist Department of Pharmacy, CaritasMedical CentreRenal Dosage Adjustment for Patients onAntimicrobials with an Automated <strong>Programme</strong>: A PilotStudySPP-P8.36 Mr WONG Ka-hei PhysiotherapistIIPhysiotherapy Department, TuenMun HospitalTranscranial Direct Current Stimulation: A NovelTechnology for Upper Limb Rehabilitation <strong>in</strong> StrokePatients — a Pilot <strong>Programme</strong>SPP-P8.37Ms CHAN ChunhungNurseConsultantDepartment of Cl<strong>in</strong>ical Oncology,Tuen Mun HospitalAudit of the End-of-life Integrated Care Pathway <strong>in</strong>Tuen Mun Hospital
62HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>sPoster PresentationsSPP-P8 – Young HA Investigators PresentationsLocation Name Post Institution Topic of PresentationSPP-P8.38Miss WONG Sot<strong>in</strong>gPhysiotherapistIIPhysiotherapy Department,Haven of Hope HospitalSPP-P8.39 Dr WU Wai Resident General Practice Cl<strong>in</strong>ic, CaritasMedical CentreSPP-P8.40 Dr MP YIU AssociateConsultantGeneral Practice Cl<strong>in</strong>ic, CaritasMedical CentreThe Figure of Eight Walk Test: Reliability andAssociations with Stroke-Specific ImpairmentsReview of Diabetes Mellitus Risk Assessment andManagement <strong>Programme</strong> (DM RAMP) Doctor SessionService <strong>in</strong> Caritas Medical Centre General PracticeCl<strong>in</strong>icA Review on Outcomes of the Multi-discipl<strong>in</strong>aryApproach <strong>in</strong> the Management of Renal Colic andMicroscopic Haematuria <strong>in</strong> Family Medic<strong>in</strong>e UrologyTriage Cl<strong>in</strong>ic
63AbstractsWednesday, 15 May 201364 Plenary SessionsP1 to P5HOSPITAL AUTHORITY CONVENTION 2013708183Parallel SessionsPS1 to PS5Special TopicsST1 to ST2Service Priorities and<strong>Programme</strong>s Free PapersSPP1 to SPP4Wednesday, 15 May
64HOSPITAL AUTHORITY CONVENTION 2013Plenary SessionsP1.1 Susta<strong>in</strong><strong>in</strong>g Quality Healthcare Services 10:45 Convention HallSav<strong>in</strong>g Healthcare: Susta<strong>in</strong><strong>in</strong>g High Quality Healthcare ServicesEaston JCare UK, UKAs National Director for Transformation for the National Health Service <strong>in</strong> England between 2009 and 2013, Jim Eastondelivered GBP£10b of f<strong>in</strong>ancial efficiencies whilst susta<strong>in</strong><strong>in</strong>g or improv<strong>in</strong>g all key quality <strong>in</strong>dicators.In this session, Jim will describe the <strong>in</strong>ternational imperative for driv<strong>in</strong>g quality and f<strong>in</strong>ancial efficiency together <strong>in</strong> order toensure the susta<strong>in</strong>ability of healthcare fund<strong>in</strong>g and delivery systems.He will outl<strong>in</strong>e those evidence-based service changes and <strong>in</strong>terventions which have the potential to deliver both f<strong>in</strong>ancial andquality ga<strong>in</strong>.Critically, Jim will describe the <strong>in</strong>tegrated model of service change <strong>in</strong> the National Health Service <strong>in</strong> England whichenabled this delivery, l<strong>in</strong>k<strong>in</strong>g f<strong>in</strong>ancial <strong>in</strong>centives, leadership development, transparent measurement, employee and publicengagement, quality improvement methods and rigorous programme management.He will reflect on the strengths and weaknesses of the methods and results and on lessons for other healthcare systems.Wednesday, 15 MayP1.2 Susta<strong>in</strong><strong>in</strong>g Quality Healthcare Services 10:45 Convention HallPatient Safety and Human FactorsHaxby EQuality and Safety Department, Royal Brompton and Harefield NHS Foundation Trust, UKPatient safety has emerged as a major concern <strong>in</strong> healthcare <strong>in</strong>ternationally over the last decade. Whilst efforts to developless <strong>in</strong>vasive procedures, produce more advanced devices and cleaner drugs have gone some way to reduc<strong>in</strong>g the risksof healthcare, focus is mov<strong>in</strong>g towards human factors as a key area for attention. Human factors is a multi-discipl<strong>in</strong>aryfield <strong>in</strong>corporat<strong>in</strong>g contributions from psychology, eng<strong>in</strong>eer<strong>in</strong>g, design, operations research and anthropometry. It coversthe science of understand<strong>in</strong>g the properties of human capability and the application of this understand<strong>in</strong>g to the design,development and deployment of systems and services. Attention to these discipl<strong>in</strong>es has resulted from exploration and<strong>in</strong>vestigation of adverse events which has revealed that human fallibility is a common cause of errors, many of which arepreventable. Healthcare systems are rarely designed to accommodate the weaknesses of those work<strong>in</strong>g with<strong>in</strong> them.However, it is clear that systems can be designed for safety and improvement science adapted from non-healthcare activitiessuch as manufactur<strong>in</strong>g is be<strong>in</strong>g used successfully to ensure safer delivery of care across the world.
Plenary Sessions65P2.1 Partner<strong>in</strong>g for Healthcare 13:15 Convention HallGlobalisation and Change Management of Healthcare DeliveryBali VFortis Healthcare Limited, Hong KongHealthcare worldwide is go<strong>in</strong>g through a dramatic change, consistent with the changes that globalisation has delivered tomany other sectors. By 2020 healthcare spend<strong>in</strong>g is projected to triple from its current base. Universally, health systemsaround the globe face challenges on cost, quality and consumer trust. A highly <strong>in</strong>formed healthcare consumer, a grow<strong>in</strong>gmiddle class <strong>in</strong> emerg<strong>in</strong>g countries, highly tra<strong>in</strong>ed physicians worldwide and <strong>in</strong>tense pressure on the constra<strong>in</strong>ed publichealthcare systems that are unable to meet the demands and expectations of patients are some of the forces beh<strong>in</strong>dthe demand for globalisation <strong>in</strong> healthcare. Globalisation is profoundly chang<strong>in</strong>g disease patterns and the availability ofhealthcare professionals worldwide is chang<strong>in</strong>g the delivery pattern of accessibility to better healthcare. Globalisation istherefore a major precipitat<strong>in</strong>g force for change <strong>in</strong> healthcare. Efficiency, productivity and cost effectiveness <strong>in</strong> conjunctionwith reliable data measurement of quality are together facilitat<strong>in</strong>g the change management of healthcare.Cl<strong>in</strong>ical transformation and cl<strong>in</strong>ical process improvement are the most profound challenges a healthcare delivery systemcan face anywhere <strong>in</strong> the world, however the forces of globalisation are facilitat<strong>in</strong>g a convergence of best practices and themature systems are adapt<strong>in</strong>g to these changes at a much faster pace. Different stakeholders from payors, hospitals andphysicians are work<strong>in</strong>g together to create standardisation and adoption of technology and Process Changes. Informationtechnology is a key driver to solve global healthcare issues and it needs organisational commitment to unlock moreefficiency and value with<strong>in</strong> the healthcare value cha<strong>in</strong>. The digitalisation of data, availability of bandwidth and the use offlexible software applications are creat<strong>in</strong>g new possibilities <strong>in</strong> diagnostics and telemedic<strong>in</strong>e across borders. By putt<strong>in</strong>g 21 stcentury technologies on top of 20 th century workflow will not yield the cost, quality and efficiency benefits. Hospitals needto redesign processes. One of the most critical challenges that both the developed and the develop<strong>in</strong>g world are fac<strong>in</strong>g isthe emerg<strong>in</strong>g shortage of healthcare professionals. Globalisation has also led to the migration and movement of healthcareworkforce which is lead<strong>in</strong>g to bridge the gap that existed <strong>in</strong> the past amongst countries on quality and availability ofhealthcare services. The confluence of all these different forces is enabl<strong>in</strong>g the rise of medical value travel and creat<strong>in</strong>g thefuture of a globalised healthcare, a trend which has created a new equation of affordability with quality of healthcare servicesand given the empowered patients global choices of healthcare dest<strong>in</strong>ations.P2.2 Partner<strong>in</strong>g for Healthcare 13:15 Convention HallHOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 MayPublic-Private Collaboration: A Successful Case <strong>in</strong> AustraliaRussell-Weisz DJFiona Stanley Hospital Commission<strong>in</strong>g, AustraliaThroughout the world, public-private partnerships (PPPs) <strong>in</strong> the healthcare arena are be<strong>in</strong>g <strong>in</strong>troduced to vary<strong>in</strong>g degrees,<strong>in</strong>clud<strong>in</strong>g full service delivery PPPs, facility management PPPs, <strong>in</strong>frastructure PPPs and franchise PPPs. Australia has hada mixed experience over the last 20 years with PPPs, primarily <strong>in</strong> the most populated eastern States focus<strong>in</strong>g on facilitiesmanagement and <strong>in</strong>frastructure PPPs.However, <strong>in</strong> Western Australia (WA), s<strong>in</strong>ce the mid 1990s there has been significant expansion of health service PPPs,primarily of the operator led full service variety. These <strong>in</strong>clude the Joondalup Health Campus, Midland Health Campus andPeel Health Campus – substantial and comprehensive health campuses serv<strong>in</strong>g over 60% of outer metropolitan Perth. Otherhealth PPPs <strong>in</strong> WA now <strong>in</strong>clude the Fiona Stanley Hospital facility management PPP, where non-cl<strong>in</strong>ical services at the new783 bed tertiary hospital <strong>in</strong> the southern suburbs of Perth (due to open <strong>in</strong> 2014) are contracted out.This presentation will exam<strong>in</strong>e one of the most successful and susta<strong>in</strong>able healthcare PPPs <strong>in</strong> WA – the Joondalup HealthCampus (JHC), from <strong>in</strong>ception <strong>in</strong> the mid 1990s to expansion of the health campus only recently completed. This has seenJHC develop from an orig<strong>in</strong>al 80 bed public “cottage” hospital to a 616 bed comprehensive facility serv<strong>in</strong>g the most rapidlygrow<strong>in</strong>g district <strong>in</strong> Australia <strong>in</strong> the northern suburbs of Perth.The JHC experience has shown that PPPs can be successful and stand the test of time – healthcare is rapidly chang<strong>in</strong>gand the private sector has demonstrated it is able to respond rapidly for the benefit of public patients. It has also shownthat expansion is possible where there is a real value for money benefit to the State, not only <strong>in</strong> operational terms but also <strong>in</strong><strong>in</strong>frastructure costs.The JHC experience has also dispelled the myth that PPPs are <strong>in</strong>appropriate health tra<strong>in</strong><strong>in</strong>g environments, with JHC nowa tra<strong>in</strong><strong>in</strong>g site for all healthcare professionals, be<strong>in</strong>g home to the busiest emergency department <strong>in</strong> WA. However, the JHCexperience shows that private operators will need to adapt to the chang<strong>in</strong>g contractual environments they f<strong>in</strong>d themselves <strong>in</strong>when either bidd<strong>in</strong>g for expansion or other opportunities.
66HOSPITAL AUTHORITY CONVENTION 2013Plenary SessionsP3.1 Utilis<strong>in</strong>g Healthcare Resources 14:30 Convention HallUSA Healthcare Reform: Early Lessons from Accountable Care OrganisationsShortell SSchool of Public Health, University of California – Berkeley, USAAs part of the Affordable Care Act, the US Centre for Medicare and Medicaid has created <strong>in</strong>centives for develop<strong>in</strong>gAccountable Care Organisations (ACOs). ACOs are physicians and hospitals and other delivery units that are accountablefor the overall cost and quality of care for a def<strong>in</strong>ed population of patients with<strong>in</strong> a predeterm<strong>in</strong>ed expenditure target. Thereare now over 300 ACOs operat<strong>in</strong>g <strong>in</strong> the US <strong>in</strong>clud<strong>in</strong>g both Medicare and private commercial <strong>in</strong>surance arrangements. Thissem<strong>in</strong>ar will present some early lessons and results based on ongo<strong>in</strong>g research. The important roles played by leadership,new care management processes, electronic health records and patient engagement will be highlighted.Wednesday, 15 MayP3.2 Utilis<strong>in</strong>g Healthcare Resources 14:30 Convention HallAustralian Healthcare ReformBennett CSchool of Medic<strong>in</strong>e, University of Notre Dame Australia, AustraliaAustralia is <strong>in</strong> an active era of national health reform. In 2008, the then Prime M<strong>in</strong>ister Kev<strong>in</strong> Rudd established an <strong>in</strong>dependentNational Health and Hospitals Reform Commission, stat<strong>in</strong>g that Australia’s health system needed reform to meet “the longterm challenges <strong>in</strong> our system: duplication, overlap, cost shift, blame shift, age<strong>in</strong>g population, explosion <strong>in</strong> chronic diseases,and long term workforce plann<strong>in</strong>g.” Follow<strong>in</strong>g a comprehensive, consultative process, the Commission presented a bluepr<strong>in</strong>tfor reform which became a national reform agenda for the next decade.A key element of the reform is a new national agreement on responsibilities, governance and f<strong>in</strong>anc<strong>in</strong>g arrangementsbetween the commonwealth and state and territory governments. The f<strong>in</strong>al agreement between Australian governmentsis reflected <strong>in</strong> the National Health Reform Agreement (February 2011) and <strong>in</strong>cludes the <strong>in</strong>troduction of an efficient activitybasedfund<strong>in</strong>g approach, national performance monitor<strong>in</strong>g and a range of nationally coord<strong>in</strong>ated functions <strong>in</strong>clud<strong>in</strong>g nationalprofessional registration, safety and quality, e-health, health workforce strategy and prevention.Other reform actions <strong>in</strong>clude new local governance arrangements for public hospitals and health services; <strong>in</strong>vestments<strong>in</strong> primary healthcare, sub-acute care, dental and mental health; a national strategy on “clos<strong>in</strong>g the gap on <strong>in</strong>digenous<strong>in</strong>equity”; a focus on strengthen<strong>in</strong>g rural health; and aged care reforms. A further review on health and medical research hasalso recently been presented and await<strong>in</strong>g response.In this plenary session, the Former Chair of the National Health and Hospitals Reform Commission will outl<strong>in</strong>e the reforms,update the progress to date, explore some of the lessons learned thus far, while identify<strong>in</strong>g gaps and improvements forfurther attention.
Plenary SessionsP4.1 Modernis<strong>in</strong>g Healthcare 16:15 Convention HallAmbulatory Care ModelStripp AAlfred Health, AustraliaThe development of an Australian elective surgery centre, <strong>in</strong>clud<strong>in</strong>g day stay service will be discussed provid<strong>in</strong>g thebackground, policy context and service imperatives for the <strong>in</strong>itiative. An outl<strong>in</strong>e of the process redesign to develop the modelof care as a basis for the capital development will be outl<strong>in</strong>ed. The developments focus on the patient journey from referral todischarge thereby streaml<strong>in</strong><strong>in</strong>g cl<strong>in</strong>ical pathways for elective surgery will be presented along with the result<strong>in</strong>g cl<strong>in</strong>ical serviceimpacts aris<strong>in</strong>g from the development of this separate, dedicated elective surgery facility.67HOSPITAL AUTHORITY CONVENTION 2013P4.2 Modernis<strong>in</strong>g Healthcare 16:15 Convention HallWednesday, 15 MayResources Plann<strong>in</strong>g for Healthcare – Operational Delivery Networks <strong>in</strong> LondonGoldsman AThe Royal Marsden NHS Foundation Trust, UKThe London Cancer Alliance (LCA) is the first of a new breed of Operational Delivery Networks be<strong>in</strong>g designed to provideacute care <strong>in</strong> the UK; br<strong>in</strong>g<strong>in</strong>g together 16 hospitals across two-thirds of London. The objective of the LCA is to ensure thatevery organisation delivers evidence-based cancer care to the same standards of excellence and value for money, <strong>in</strong> aconstra<strong>in</strong>ed f<strong>in</strong>ancial climate.This presentation will provide <strong>in</strong>sights <strong>in</strong>to the design and implementation of the modernisation programme; the evidencerequired for ensur<strong>in</strong>g cl<strong>in</strong>ical engagement; and a new approach to align<strong>in</strong>g healthcare strategy with service delivery.Service transformation is based on a new model of care for a health economy that provides cancer services for eight millionpeople and cost<strong>in</strong>g, annually, GBP£2.2b; and where costs are expected to <strong>in</strong>crease by GBP£400m over the next five years.Operational Delivery Networks are cl<strong>in</strong>ically led and governed by a board that comprises representatives from each hospitalprovider. They are responsible for deliver<strong>in</strong>g specified care pathways developed by cl<strong>in</strong>icians and for develop<strong>in</strong>g strongrelationships with academic health science networks to ensure that the evidence from research is more rapidly adopted <strong>in</strong>tostandard patient care.A scientific approach to modernisation uses patient data, at hospital episode level and across the health economy, to provideevidence and tools to drive resourc<strong>in</strong>g decisions, to promote better service <strong>in</strong>tegration and to track performance. Thiscommon approach has supported the exact<strong>in</strong>g cl<strong>in</strong>ical scrut<strong>in</strong>y and engagement required to deliver mean<strong>in</strong>gful change forpatients, a reduction <strong>in</strong> the costs of cancer care and a more susta<strong>in</strong>able f<strong>in</strong>ancial model for cancer providers.The Royal Marsden Hospital, a specialist cancer provider, is lead<strong>in</strong>g this transformation where the traditional “hub andspoke” model of service delivery has been transformed as part of the modernis<strong>in</strong>g drive.
68HOSPITAL AUTHORITY CONVENTION 2013Plenary SessionsP5.1 Ensur<strong>in</strong>g Emergency Preparedness 10:45 Theatre 1Diagnostic Strategy and Laboratory Preparedness <strong>in</strong> the Face of Emerg<strong>in</strong>g DiseasesTong CYWBarts Health National Health Service Trust, UKEmerg<strong>in</strong>g <strong>in</strong>fections occur regularly <strong>in</strong> the history of mank<strong>in</strong>d. It could be due to a recognised <strong>in</strong>fection spread<strong>in</strong>g to newareas or populations. It should be a known disease caused by <strong>in</strong>fection; a previously unrecognised <strong>in</strong>fection appear<strong>in</strong>g<strong>in</strong> areas where the habitat is chang<strong>in</strong>g or an “old” <strong>in</strong>fection re-emerg<strong>in</strong>g because it has become resistant to treatment oras a result of a breakdown <strong>in</strong> public health <strong>in</strong>itiatives. A new <strong>in</strong>fection can also emerge as a result of changes <strong>in</strong> exist<strong>in</strong>gmicroorganisms. Pandemic <strong>in</strong>fluenza due to <strong>in</strong>fluenza A virus with a new haemagglut<strong>in</strong><strong>in</strong> and/or neuram<strong>in</strong>idase subtypeis a typical example. Emerg<strong>in</strong>g <strong>in</strong>fections can also be due to a novel <strong>in</strong>fectious agent described for the first time. SARScoronavirus and the recently described novel coronavirus, hCoV-EMC, are good examples of this latter category. Theexperience of diagnosis and management of the first case of a novel coronavirus <strong>in</strong> the United K<strong>in</strong>gdom is described <strong>in</strong> thispresentation. In England, a network of regional public health laboratories serve as screen<strong>in</strong>g laboratories, while the centralreference laboratory perform confirmation test. The respective roles, and <strong>in</strong>teraction between the regional laboratories andthe reference laboratory will be discussed. The need to develop new assays whenever a new <strong>in</strong>fection appears and to updateexist<strong>in</strong>g assays when an <strong>in</strong>fectious agent changes rema<strong>in</strong> a great challenge. Other challenges <strong>in</strong>clude fragmentation oflaboratory service due to privatisation, f<strong>in</strong>ancial constra<strong>in</strong>t and lack of engagement with the public.Wednesday, 15 MayP5.2 Ensur<strong>in</strong>g Emergency Preparedness 10:45 Theatre 1Structur<strong>in</strong>g the Medical Response to Major Incidents: the Power of Major Incident Medical Management andSupport (MIMMS)Mackway-Jones KEmergency Department, Manchester Royal Infirmary, UKIt is never easy to manage a major <strong>in</strong>cident s<strong>in</strong>ce the number and nature of the casualties is, by def<strong>in</strong>ition, greater than healthservice resources that are available to deal with them. To overcome this challenge, special plans need to be <strong>in</strong>voked andpractitioners need to be managed and practised <strong>in</strong> different ways. It is necessary to ensure that all health practitioners arefamiliar with the environment and that they understand the aims and limitations of their cl<strong>in</strong>ical practice. The Major IncidentMedical Management and Support (MIMMS) concepts provide a structured approach to this problem with<strong>in</strong> a pedagogicallysound and familiar framework.MIMMS promotes an all hazards approach that spans preparation, medical management and medical support. The approachto medical management and medical support is summarised by the letters CSCATTT - often referred as the ABC of major<strong>in</strong>cidents.The MIMMS structured approach has been used <strong>in</strong> many civilian major <strong>in</strong>cidents (such as the London bomb<strong>in</strong>gs andJapanese tsunami), as well as be<strong>in</strong>g <strong>in</strong> almost daily use for <strong>in</strong>cident management by the military. This session will summarisethe MIMMS concepts and tra<strong>in</strong><strong>in</strong>g opportunities and will seek to illustrate their relevance <strong>in</strong> hospital and pre-hospitalenvironments around the world.
Plenary SessionsP5.3 Ensur<strong>in</strong>g Emergency Preparedness 10:45 Theatre 1Disaster Mental Health PreparednessBrymer MNational Center for Child Traumatic Stress UCLA, USAThis plenary session will provide an overview of the modern pr<strong>in</strong>ciples and strategies for public disaster mental healthpreparedness. Lessons learned from disasters worldwide have shown that proper preparedness have mitigated the mentalhealth impact of disasters on those directly and <strong>in</strong>directly impacted. Effective preparedness strategies highlight the need toestablish effective partnerships, all-hazards plann<strong>in</strong>g, pre-event plann<strong>in</strong>g for vulnerable populations, ongo<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g andpractice, and assess<strong>in</strong>g and address<strong>in</strong>g local gaps. Pre-event messages need to address the community and <strong>in</strong>dividuallevels and should be communicated rapidly, consistently, and clearly. Coord<strong>in</strong>ation among response organisations andagencies is essential, <strong>in</strong>clud<strong>in</strong>g us<strong>in</strong>g common protocols, practices, and procedures. Plann<strong>in</strong>g has to monitor technology<strong>in</strong>novations and how to effectively communicate risk messages with various media and social media outlets (e.g. twitter,face<strong>book</strong>). F<strong>in</strong>ally, strategies to promote resilience at the <strong>in</strong>dividual, family, and community levels will be discussed.69HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
70HOSPITAL AUTHORITY CONVENTION 2013Parallel SessionPS1.1 Emergency: Are We Prepared? How We Do It? 13:15 Theatre 1Disaster Response — from Scene to HospitalShum KLHong Kong Fire Services DepartmentHong Kong, though a safe city as compared with others, has never been free from the attack of disasters, no matter manmadeor natural. The Ambulance Command of the Fire Services Department (FSD) is the sole emergency paramedicambulance service provider <strong>in</strong> Hong Kong which is now operat<strong>in</strong>g a fleet of more than 300 ambulances and a team of nearly2,800 paramedics.Form<strong>in</strong>g one of the essential r<strong>in</strong>gs of the rescue cha<strong>in</strong>, the speaker will focus on how the Emergency Ambulance Service ofthe FSD has been equipp<strong>in</strong>g itself to deal with all the possible attack of the disaster. The preparedness and read<strong>in</strong>ess of theservice, the skills and equipment of the paramedics, and the cooperation of the paramedics with other essential services willalso be the focal po<strong>in</strong>ts of the talk.Through the <strong>in</strong>terflow, it is hoped that audience will be able to have a better understand<strong>in</strong>g of the ability of the AmbulanceService on how to handle and take care of the casualties dur<strong>in</strong>g the very first stage of any disaster – from scene to hospital;as well as how to strengthen the role of Ambulance Service <strong>in</strong> the disaster response system.Wednesday, 15 MayPS1.2 Emergency: Are We Prepared? How We Do It? 13:15 Theatre 1The HOUR <strong>in</strong> Emergency DepartmentsChan LWAccident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, Hong KongHong Kong is a global f<strong>in</strong>ance centre. Emergency preparedness aga<strong>in</strong>st all disasters is of great importance <strong>in</strong> ensur<strong>in</strong>gpolitical and economic stability. Despite <strong>in</strong>creas<strong>in</strong>g experience after several civil disasters <strong>in</strong> recent years, disaster response<strong>in</strong> the Accident and Emergency (A&E) department with<strong>in</strong> the first hour is always difficult and challeng<strong>in</strong>g. Information aboutthe <strong>in</strong>cident dur<strong>in</strong>g this acute phase is always scanty, contradictory and fragmentary. Moreover <strong>in</strong>cidents may occur afteroffice hour when hospital manpower is usually tight. Over response may lead to false implementation of hospital disastercont<strong>in</strong>gency plan, subsequent wastage of resource and disruption of hospital service. Under response may lead to totalunpreparedness when the first batch of victims turn up unexpectedly.Are we now better prepared and wiser after all the years? In this presentation, first hour of emergency response <strong>in</strong> the A&Edepartment, the uncerta<strong>in</strong>ty and difficulty faced will be shared through speaker’s personal experience <strong>in</strong> recent major civildisasters, <strong>in</strong>clud<strong>in</strong>g the Lamma Island mar<strong>in</strong>e <strong>in</strong>cident, and the fatal bus crash at the A Kung Ngam Road. Improvementmeasures are suggested for better performance dur<strong>in</strong>g this critical period.
Parallel SessionPS1.3 Emergency: Are We Prepared? How We Do It? 13:15 Theatre 1Modernis<strong>in</strong>g Disaster Mental Health Response and RecoveryBrymer MNational Center for Child Traumatic Stress UCLA, USAThis workshop will provide an overview of the key components <strong>in</strong> establish<strong>in</strong>g a disaster mental health response programme.Interventions and services should be proactive, protective, pragmatic, and pr<strong>in</strong>ciple-driven, <strong>in</strong>clud<strong>in</strong>g provid<strong>in</strong>g a sense ofsafety, promot<strong>in</strong>g calm<strong>in</strong>g activities, support<strong>in</strong>g connectedness, foster<strong>in</strong>g self and community efficacy, and <strong>in</strong>creas<strong>in</strong>g hopeat all stages. A stepped-care approach is needed to ensure that services are meet<strong>in</strong>g the various needs of all <strong>in</strong>dividualsand are appropriate based on tim<strong>in</strong>g. Tier one services <strong>in</strong>clude outreach, public health <strong>in</strong>formation, needs assessments, andPsychological First Aid (PFA) approaches to the affected population. PFA <strong>in</strong>cludes stabilisation of the affected population;address<strong>in</strong>g immediate health, mental health, and safety concerns; provid<strong>in</strong>g practical assistance; enhanc<strong>in</strong>g cop<strong>in</strong>gstrategies and the use of community and social support resources; provid<strong>in</strong>g <strong>in</strong>formation on common stress reactionsand cautions about risk-related behaviour; and l<strong>in</strong>kage with available community support resources. Tier two providesmore specialised <strong>in</strong>terventions for those with moderate persist<strong>in</strong>g distress. Specialised trauma and grief skills-build<strong>in</strong>g<strong>in</strong>terventions, such as skills for psychological recovery can be implemented by paraprofessionals. Tier three providesspecialised psychological services for those <strong>in</strong>dividuals who require immediate and/or <strong>in</strong>tensive <strong>in</strong>terventions. Variousevidence-based practices, web-based tra<strong>in</strong><strong>in</strong>g courses, and other tools/resources (e.g., mobile apps, children’s <strong>book</strong>s,talk<strong>in</strong>g po<strong>in</strong>ts) will be highlighted.71HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
72HOSPITAL AUTHORITY CONVENTION 2013Parallel SessionPS2.1 HA Improvement Initiatives 14:30 Theatre 1The Journey of Change for Non-emergency Ambulance Transfer Service (NEATS): From an Ombudsman Case toa Modernised ServiceLee BCMBus<strong>in</strong>ess Support Services Department, Cluster Services Division, Hospital Authority, Hong KongIn Hong Kong, the Hospital Authority (HA) took over Non-emergency Ambulance Transfer Service (NEATS) from the FireServices Department <strong>in</strong> 1994 for transportation of HA patients to and from hospitals/cl<strong>in</strong>ics and homes. In view of compla<strong>in</strong>tsabout the delay and uncerta<strong>in</strong>ty of NEATS provided by the HA, the Ombudsman commenced a direct <strong>in</strong>vestigation on themanagement of NEATS by the HA <strong>in</strong> September 2009 and put forth recommendations to the HA for management of NEATS<strong>in</strong> December 2010.This presentation covers various strategies and improvement programmes implemented <strong>in</strong> hospitals for NEATS withadditional fund<strong>in</strong>g from the government. The strategies <strong>in</strong>clude: (1) Enhancement of governance structure, policy andguidel<strong>in</strong>es; (2) expansion of capacity by <strong>in</strong>creas<strong>in</strong>g the number of vehicles and staff; (3) enhancement of staff competencyby structured tra<strong>in</strong><strong>in</strong>g for NEATS staff; (4) review of performance standards and monitor<strong>in</strong>g of Key Performance Indicators;(5) enhancement of system tools and support to facilitate strategic plann<strong>in</strong>g and demand management; and (6) staffcommunications, recognition and engagement.Wednesday, 15 MayProblems related to NEATS also occur <strong>in</strong> other places <strong>in</strong> the world such as <strong>in</strong> Ontario <strong>in</strong> 2011, the Canadian governmentpledged to implement the Ombudsman’s recommendations on regulat<strong>in</strong>g the medical transportation services <strong>in</strong>dustryto address the problems of unsafe vehicles and untra<strong>in</strong>ed staff. Consultation on non-emergency patient transport <strong>in</strong>Wales <strong>in</strong>clud<strong>in</strong>g the current system’s failure <strong>in</strong> meet<strong>in</strong>g patients’ need was reviewed by the Welsh government. Taipei citygovernment is fac<strong>in</strong>g the challenge of “faked” ambulance vehicles run by private ambulance operators.Insights of future provision of non-emergency patient transport services <strong>in</strong> Hong Kong with reference to the experiences andpractices of other cities will be shared.PS2.2 HA Improvement Initiatives 14:30 Theatre 1How Information Technology Has Improved Quality and Safety of Cl<strong>in</strong>ical ServicesCheung NTHealth Informatics Section, Hospital Authority, Hong KongS<strong>in</strong>ce the early 1990s, the Hospital Authority (HA) has developed an <strong>in</strong>house comprehensive electronic medical recordsystem, the Cl<strong>in</strong>ical Management System (CMS). Currently the HA is <strong>in</strong> the process of mov<strong>in</strong>g to the third generation — CMSIII, which is a huge undertak<strong>in</strong>g proceed<strong>in</strong>g <strong>in</strong> two phases: <strong>in</strong> Phase one, the CMS was revamped onto a modern technicalplatform to allow susta<strong>in</strong>able enhancements for the com<strong>in</strong>g decade; <strong>in</strong> Phase two (start<strong>in</strong>g this year), CMS will deliver majornew capabilities on this modern platform.The four strategic objectives of CMS III were identified <strong>in</strong> 2007 as: (1) improve the outcome of care; (2) facilitate the processesof care; (3) further develop the content of electronic record; and (4) extend the benefits of eHealth to the community.Enhanc<strong>in</strong>g the quality and safety of cl<strong>in</strong>ical service delivery <strong>in</strong> the HA has always been the first objective of CMS, and DrCheung will share examples of the improvements that the CMS has enabled over the past two decades. Dr Cheung will thenlook forward to Phase two and discuss some of the major strategies and directions of this Phase. Innovations <strong>in</strong> cl<strong>in</strong>icalprocesses are constantly be<strong>in</strong>g developed by the HA and the capabilities that will be provided <strong>in</strong> Phase II are necessary tosupport such <strong>in</strong>novations, and to enable higher quality and safer cl<strong>in</strong>ical care <strong>in</strong> the HA <strong>in</strong> future.
Parallel SessionPS2.3 HA Improvement Initiatives 14:30 Theatre 1The Road Ahead for Hospital Authority Transplant Coord<strong>in</strong>ation Service: Silver AnniversaryKoo JWMTransplant Coord<strong>in</strong>ation Services, Queen Mary Hospital, Hong KongIntroductionHong Kong Transplant Coord<strong>in</strong>ation Service was first established <strong>in</strong> August 1988. After 25 years, the Service reaches itsSilver Anniversary this year. Look<strong>in</strong>g back, the Service has undergone significant evolutionary changes and development<strong>in</strong> the past two decades. This presentation will summarise the service <strong>in</strong> terms of past and present. Our challenges,opportunities and threats will be analysed to shed lights on the road ahead.PastWe grew from one part-time staff <strong>in</strong> 1988 to seven full-time at present. Each Transplant Coord<strong>in</strong>ator takes care of a sizableportfolio and needs to prepare to work round the clock if required (seven days a week and 24 hours per day). In 1996, OrganProcurement System (OPS) was developed as an important milestone. It is a direct, onl<strong>in</strong>e, computerised registry captur<strong>in</strong>gall data of the deceased donors. It thus facilitates Transplant Coord<strong>in</strong>ators to systematically analyse the captured data forservice improvement. 25 years ago, organ donation was considered a taboo among the general public. But nowadays, withpublic education and successful life-sav<strong>in</strong>g stories, our community has become far more receptive to the “Gift of Life” withorgan donation be<strong>in</strong>g valued as a noble act <strong>in</strong> our society.73HOSPITAL AUTHORITY CONVENTION 2013PresentIn 2009, we started a share call system aim<strong>in</strong>g to relieve our heavy and unpredictable workload borne by <strong>in</strong>dividual TransplantCoord<strong>in</strong>ator. In 2012, each Transplant Coord<strong>in</strong>ator has his/her own iPad to facilitate effective and timely communication. Inthe same year, Cl<strong>in</strong>ical Attachment and Skill Enhancement (CASE) programme was implemented to help <strong>in</strong>ject<strong>in</strong>g new blood<strong>in</strong>to the service. Currently we have a “one cluster one standard” policy; our organisational structure are ma<strong>in</strong>ta<strong>in</strong>ed at simpleand s<strong>in</strong>gle level; team members have different values and different practices to achieve the s<strong>in</strong>gle goal; and each teammember work <strong>in</strong>dependently.FutureThe current situation may have developed <strong>in</strong>to a crisis situation which will underm<strong>in</strong>e the overall operation of the service.However, the word “crisis”( 危 機 )<strong>in</strong> Ch<strong>in</strong>ese carries a very special mean<strong>in</strong>g: threats and opportunities always co-exist.Hav<strong>in</strong>g potential threats <strong>in</strong> our service would naturally br<strong>in</strong>g <strong>in</strong> opportunities for us to help enhance and align our service. Ifwe can ride on these opportunities to eng<strong>in</strong>eer a successful reform, Transplant Coord<strong>in</strong>ation Service will see a breakthroughto a new horizon.Wednesday, 15 May
74HOSPITAL AUTHORITY CONVENTION 2013Parallel SessionPS3.1 Engag<strong>in</strong>g Staff for Performance 16:15 Theatre 1Tra<strong>in</strong><strong>in</strong>g and Support<strong>in</strong>g Managers to Improve Staff PerformanceClay GGrayl<strong>in</strong> Ltd., AustraliaThis session will look at the challenges that healthcare managers face <strong>in</strong> motivat<strong>in</strong>g staff to perform at a high level and theskills required to handle underperformers. A central theme is that managers need to be tra<strong>in</strong>ed <strong>in</strong> conversational skills andneed to be supported <strong>in</strong> work environment to practise these skills.This topic will be presented from a practical perspective. The speaker has worked for over 20 years <strong>in</strong> senior humanresources roles <strong>in</strong> the Australian health <strong>in</strong>dustry. Research shows that managers across all <strong>in</strong>dustries miss the opportunitiesto improve productivity through failures to <strong>in</strong>teract effectively at an <strong>in</strong>terpersonal level. The health <strong>in</strong>dustry has particularchallenges to overcome as managers work <strong>in</strong> a complex environment of professional sub-cultures with frequent tensionsaris<strong>in</strong>g between highly directive managers and those who like to work <strong>in</strong> a more collaborative style.Effective performance management does not occur through annual performance plann<strong>in</strong>g and review meet<strong>in</strong>gs alone;although this is an important element <strong>in</strong> an overall process and the presenter will put forward some ideas on how tomake these meet<strong>in</strong>gs more effective. Susan Scott, author of “Fierce Conversations” says “our lives succeed or fail oneconversation at a time” and a manager succeeds or fails <strong>in</strong> team build<strong>in</strong>g and staff engagement through each of her or hisdaily conversations. Conversational failures results <strong>in</strong> a common <strong>in</strong>dustry problem of managers allow<strong>in</strong>g underperformanceto manifest to a po<strong>in</strong>t where considerable resources are consumed <strong>in</strong> formal discipl<strong>in</strong>ary processes.Wednesday, 15 MayReal life examples will be used to illustrate some of the ideas be<strong>in</strong>g put forward along with some of the presenter’s favoured“models” for design<strong>in</strong>g appropriate management tra<strong>in</strong><strong>in</strong>g programmes. An outl<strong>in</strong>e on some of the best practice leadershipand management development programmes offered through Australian public health services and some of the large not-forprofitoperators will also be provided.PS3.2 Engag<strong>in</strong>g Staff for Performance 16:15 Theatre 1Motivat<strong>in</strong>g Staff for PerformanceLam WKThe Executive Council, Hong Kong Special Adm<strong>in</strong>istrative Region GovernmentEssences of performance <strong>in</strong> the public sector <strong>in</strong>clude the follow<strong>in</strong>gs:(1) Embrace diversity;(2) encourage openness;(3) enlist the <strong>in</strong>novative; and(4) enhance fairness.
Parallel Session75PS4.1 New Horizons of Nurs<strong>in</strong>g Practices 14:30 Theatre 2Multi-discipl<strong>in</strong>ary Case Management Model for People with Severe Mental IllnessMui JCommunity Psychiatric Service, Castle Peak Hospital, Hong KongIntroductionPeople with severe mental illness have different needs and risks at different stages of their illness and recovery. This groupof people is particularly difficult to <strong>in</strong>tegrate back to the community with issues of their illness, social stigma, fragmentedservice provision, <strong>in</strong>sufficient workforce, and limited collaboration with community partners. In 2010, the Hong Konggovernment had <strong>in</strong>jected new fund<strong>in</strong>g to support the development of Recovery Support <strong>Programme</strong> for severely mentally illpeople <strong>in</strong> the community. We have taken this opportunity to revamp the community psychiatric service.MethodA three-tiered multi-discipl<strong>in</strong>ary case management model was developed <strong>in</strong> an attempt to overcome the identified obstaclesand facilitate care that addresses the wide range of needs of these clients liv<strong>in</strong>g <strong>in</strong> the community. The development of thethree tiers was based on the multi-dimensional criteria of cl<strong>in</strong>ical state and psychosocial function<strong>in</strong>g of patients, who wereallocated to different levels of care (low, medium and high) accord<strong>in</strong>g to the result of a unified needs and risks assessment.The levels of care aimed at giv<strong>in</strong>g <strong>in</strong>dication to the <strong>in</strong>tensity of care and caseload weight<strong>in</strong>g. It also served as guidanceto case managers on cl<strong>in</strong>ical decision mak<strong>in</strong>g and choice of care packages. Every patient was assigned a case managerresponsible for their bio-psycho-social needs on a long term basis. The allocation of case manager (nurses, occupationaltherapists and social workers) was based on match<strong>in</strong>g the needs of <strong>in</strong>dividual patients with the expertise of staff. An<strong>in</strong>dividualised care plan with regular review was devised to align the aspirations and goals of patients, carers and casemanagers. Regular meet<strong>in</strong>gs and close collaboration with our community partners enlarged the safe and support networksto service users.ResultsThis hybrid model consists of the most effective community psychiatric service approaches tailored to the needs of patients<strong>in</strong> different tiers. These <strong>in</strong>clude crisis resolution, functional assertive community outreach and cl<strong>in</strong>ical case management.It is a one-stop service for patients with different needs. The levels of care for an <strong>in</strong>dividual patient could be stepped upand down with<strong>in</strong> the same team accord<strong>in</strong>g to the needs identified. Such practice enhances cont<strong>in</strong>uity of care, improvescollaboration with community partners and promotes efficient utilisation of workforce.ConclusionThis model provides a framework of organis<strong>in</strong>g community psychiatric services <strong>in</strong> a systematic and coord<strong>in</strong>ated way. Itserves as a framework to develop cl<strong>in</strong>ical care pathways and fidelity scales for effective cl<strong>in</strong>ical practices.HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
76HOSPITAL AUTHORITY CONVENTION 2013Parallel SessionPS4.2 New Horizons of Nurs<strong>in</strong>g Practices 14:30 Theatre 2Emerg<strong>in</strong>g Roles of Nurse Consultant <strong>in</strong> Cont<strong>in</strong>ence CareChan BSKUnited Christian Hospital, Hong KongIncont<strong>in</strong>ence is be<strong>in</strong>g <strong>in</strong>creas<strong>in</strong>gly recognised as a significant problem <strong>in</strong> the past decade. The World Health Organisationhas acknowledged this as a priority healthcare issue. Incont<strong>in</strong>ence can lower a person’s quality of life. Some people becomehouse-bound as a result of <strong>in</strong>cont<strong>in</strong>ence, which exerts a burden to healthcare services. Cont<strong>in</strong>ence promotion should be<strong>in</strong>tegrated <strong>in</strong>to acute hospital sett<strong>in</strong>gs as well as homes, communities, rehabilitation units, primary care and long term care.Cont<strong>in</strong>ence nurses can take up more roles to coord<strong>in</strong>ate care and manage cases with bladder or bowel problems.The cont<strong>in</strong>ence nurse consultants provide expert cl<strong>in</strong>ical advices to clients, carers and other healthcare professionals ofthe specialty. Their leadership facilitates ongo<strong>in</strong>g development of cl<strong>in</strong>ical practice. They also conduct and utilise researches<strong>in</strong> provision of cl<strong>in</strong>ical services. They contribute to the development and delivery of cont<strong>in</strong>ence education programme fromhospital to community, and develop cont<strong>in</strong>ence specialty policies and care delivery model to enhance quality of cont<strong>in</strong>encecare.Wednesday, 15 MayPS4.3 New Horizons of Nurs<strong>in</strong>g Practices 14:30 Theatre 2The Roles and Challenges of Wound Nurse Consultant <strong>in</strong> Hong KongLee WKDepartment of Surgery, Queen Mary Hospital, Hong KongWound heal<strong>in</strong>g is a complex and sometimes prolonged process. Some patients may take weeks to months, or even years forthe wounds to completely heal. The <strong>in</strong>patient care of these patients exerts a substantial burden on hospital resources. Even ifchronic wounds, such as venous ulcers, are managed <strong>in</strong> the community, the process of wound care and heal<strong>in</strong>g is still tax<strong>in</strong>gto the patients and their families with significant adverse effects on their quality of life.With<strong>in</strong> the Hospital Authority, the scope of wound care services <strong>in</strong>cludes nurs<strong>in</strong>g care for patients with enterostomalfistulae, foot and leg ulcers, pressure ulcers, malignant ulcers, atypical wounds, dra<strong>in</strong>s and complicated surgical wounds.Successful wound management requires a multi-discipl<strong>in</strong>ary approach. The wound specialists who have a strong knowledgeand experience <strong>in</strong> wound care are pivotal <strong>in</strong> provid<strong>in</strong>g and coord<strong>in</strong>at<strong>in</strong>g the cl<strong>in</strong>ical services. These <strong>in</strong>clude evidencebasedwound management, staff and patient education, control of wound-related costs; implement<strong>in</strong>g quality improvementactivities, as well as wound protocol and formulary development.The Wound Nurse Consultant serves as a cl<strong>in</strong>ical resource for patient care <strong>in</strong> the area of wound management. Nurseconsultant enables the multi-discipl<strong>in</strong>ary team to work effectively and ensure that the services are developed to be patientcentred.This responsibility is carried out through specialist cl<strong>in</strong>ical practice, professional leadership, education, research,and professional development. Through the expert advice and follow-up service of wound specialists, the objectives of betterpatient care and management, reduction of complications, hastened recovery, and sav<strong>in</strong>g of resources will be achieved.
Parallel Session77PS4.4 New Horizons of Nurs<strong>in</strong>g Practices 14:30 Theatre 2Shar<strong>in</strong>g of the Nurse Consultant Role <strong>in</strong> Emergency Care ServiceChung JAccident and Emergency Department, Pr<strong>in</strong>ce of Wales Hospital, Hong KongWith the advancement of medical technology and treatment, and the ris<strong>in</strong>g expectations and demands of the public, theemergency department (ED) not only performs a “gate-keep<strong>in</strong>g” role to enhance ambulatory and short stay services, butalso extends its scope of services to achieve better patient health outcomes <strong>in</strong> l<strong>in</strong>e with <strong>in</strong>ternational standards. Nowadays,care services provided to patients <strong>in</strong> EDs are far more complex. Many urgent and emergency conditions, for <strong>in</strong>stance, acutemyocardial <strong>in</strong>farction, acute ischemic stroke and major trauma, are time-critical. These require time-critical and life-sav<strong>in</strong>gcare and treatment. Emergency services play a vital role <strong>in</strong> patient health outcomes through immediate assessment andtimely treatment with<strong>in</strong> and even outside EDs.The role of nurse consultant (NC) was first <strong>in</strong>troduced <strong>in</strong> emergency departments <strong>in</strong> 2012. The NC of emergency care isa cl<strong>in</strong>ical nurs<strong>in</strong>g leader who leads a group of nurses and collaborates with multi-discipl<strong>in</strong>ary healthcare team to provideoptimal care to patients and ensure the provision of guaranteed high quality and safe emergency nurs<strong>in</strong>g care for patients atall times. There is a particular focus on high risk and high volume patient conditions, both at emergency department level andat cluster level. The major roles of a NC <strong>in</strong> emergency care focus on the provision of direct patient care, consultancy roles <strong>in</strong>cl<strong>in</strong>ical services, education, research, quality management and professional development. With these roles and functions ofa NC, the ultimate goal is to enhance triage and fast track services to shorten the wait<strong>in</strong>g and process<strong>in</strong>g time for acute care,improve <strong>in</strong>ter-facility transfer services, enhance patient safety and quality of healthcare. The speaker will share the servicemodel of NC <strong>in</strong> emergency care and her work experience <strong>in</strong> the new role.HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
78HOSPITAL AUTHORITY CONVENTION 2013Parallel SessionPS5.1 New Horizons of Allied Health Practices 16:15 Theatre 2Roles and Challenges of Diagnostic Radiographer Consultant <strong>in</strong> Hong KongHo SSYDepartment of Imag<strong>in</strong>g and Interventional Radiology, Pr<strong>in</strong>ce of Wales Hospital, Hong KongThe first diagnostic radiographer consultant came to service <strong>in</strong> Hong Kong <strong>in</strong> 2009 as a modernisation of radiographers’practice <strong>in</strong> Hospital Authority (HA) with an aim to improve the imag<strong>in</strong>g service throughput. A Career Progression Model <strong>in</strong>Ultrasonography, CPM (U/S) was adopted as a pilot model for modernisation <strong>in</strong> which three tiers of practis<strong>in</strong>g diagnosticradiographers (ultrasonographers) were <strong>in</strong>troduced: practitioners, advanced practitioners and consultants, who possessdifferent levels of competence, roles and responsibilities.The consultant is required to work <strong>in</strong>dependently and supervise the ultrasonographers <strong>in</strong> daily service so that radiologistscan be spared to perform more complex tasks or to oversee parallel sessions that are run by ultrasonographers. Thispractice is proved to be cost-effective because ultrasound service throughput has been shown to <strong>in</strong>crease by about 14% <strong>in</strong>n<strong>in</strong>e departments where CPM (U/S) is <strong>in</strong> place.With enhanced roles, the consultant not only delivers service as a technological expert but also performs tra<strong>in</strong><strong>in</strong>g andadm<strong>in</strong>istrative roles <strong>in</strong> cluster and the HA. An Advanced Specialty <strong>Programme</strong> for ultrasonographers and three ultrasoundsem<strong>in</strong>ars were organised between 2009 and 2012. In addition, annual stock-tak<strong>in</strong>g of ultrasonographers’ CME activities andpractice, audit on accuracy of ultrasonographers’ drafted reports, and different satisfaction surveys on ultrasonographers’practice were also performed.Wednesday, 15 MayHowever, due to tight manpower of radiographers, implementation of ultrasonographers practice is compromised. Thisunfavourable situation is aggravated by <strong>in</strong>creas<strong>in</strong>g compla<strong>in</strong>ts of musculoskeletal discomfort or pa<strong>in</strong> by ultrasonographersdue to long-hour duty <strong>in</strong> ultrasound scann<strong>in</strong>g despite ergonomic devices are provided <strong>in</strong> service.In order to relieve the situation, it is advised that actively practis<strong>in</strong>g ultrasonographers should be allowed to have job rotationso that appropriate rest can be ensured. With the success of CPM (U/S), similar models should be rolled out <strong>in</strong> other imag<strong>in</strong>gmodalities so as to achieve optimal imag<strong>in</strong>g service delivery to patients.
Parallel SessionPS5.2 New Horizons of Allied Health Practices 16:15 Theatre 2New Roles of Occupational Therapist <strong>in</strong> Mental Health Service – Enhanc<strong>in</strong>g Access to PsychologicalInterventions for People with Common Mental DisordersLee JLY, Chan HW, Choi YY, Lak D, Lam CF, Shih S, Tam P, Yeung EWork<strong>in</strong>g Group <strong>in</strong> Common Mental Disorder Cl<strong>in</strong>ics Service, Coord<strong>in</strong>at<strong>in</strong>g Committee <strong>in</strong> Occupational Therapy, HospitalAuthority, Hong KongIntroductionCommon mental disorders are highly prevalent and associated with direct and <strong>in</strong>direct medical cost as well as nonmedicalcost. The <strong>in</strong>novative establishment of Early Symptom Management <strong>Programme</strong> <strong>in</strong> 2008 provided by occupationaltherapy specialists tra<strong>in</strong>ed <strong>in</strong> focused psychological <strong>in</strong>terventions and adjunctive lifestyle redesign proved its effectiveness<strong>in</strong> symptom alleviation, function and quality of life improvement of patients. In 2010, the programme was <strong>in</strong>tegrated withCommon Mental Disorder Cl<strong>in</strong>ics (CMDCs) and extended to collaborate with primary care to enhance treatment of generalout-patients.Objectives(1) To improve access to psychological <strong>in</strong>tervention; (2) to improve mental wellbe<strong>in</strong>g, enhance self-management and preventcomplications; and (3) to facilitate <strong>in</strong>terface and discharge to primary care services.79HOSPITAL AUTHORITY CONVENTION 2013MethodologyA “Pre-test” vs. “Post-test’ design was employed to measure the cl<strong>in</strong>ical effectiveness. The outcome was compared by<strong>in</strong>dependent group t-test. Subjects <strong>in</strong>clude patients from CMDCs. Outcome measures: (1) assessment on severity ofsymptoms; (2) self-rat<strong>in</strong>g on wellbe<strong>in</strong>g; and (3) patient satisfaction.ResultsOver 1,000 target patients were treated at eight allied health cl<strong>in</strong>ics. Positive outcomes were found <strong>in</strong>clud<strong>in</strong>g symptomreductions and improved subjective wellbe<strong>in</strong>g. There was significant difference between the pre- and post-treatmentmeasures (p three months.ConclusionsWith establishment of occupational therapist (OT) specialist <strong>in</strong> mental health, advanced skills and new models were put <strong>in</strong>topractice to meet <strong>in</strong>creas<strong>in</strong>g needs and new demand of the Hospital Authority service like Case Management programmes<strong>in</strong> community psychiatry and Early Assessment Service for Young People with Early Psychosis (EASY) services. Furtheradvances <strong>in</strong> Wellbe<strong>in</strong>g Enhancement programmes, Cognitive Tra<strong>in</strong><strong>in</strong>g for the Severe Mentally Ill and Consumer ParticipationProjects are under development. Promis<strong>in</strong>g results <strong>in</strong> the past five years signified the capability, read<strong>in</strong>ess and enthusiasm ofOT workforce to take up enhanced roles <strong>in</strong> other specialties with organisational support.Wednesday, 15 May
80HOSPITAL AUTHORITY CONVENTION 2013Parallel SessionPS5.3 New Horizons of Allied Health Practices 16:15 Theatre 2Musculoskeletal Physiotherapy ServiceKwong SPhysiotherapy Department, Ruttonjee and Tang Shiu K<strong>in</strong> Hospitals, Hong KongThe Musculoskeletal Physiotherapy Screen<strong>in</strong>g, Assessment, Fast-track Education and Management <strong>Programme</strong> (SAFE)were implemented <strong>in</strong> eight hospitals to provide timely and appropriate care to patients referred to Orthopaedics OutpatientService. The programme started with sp<strong>in</strong>e triage and early Physiotherapy (PT) <strong>in</strong>tervention, which has beenextended to other conditions. With enhancement of organisational triage safety, efficacy and accessibility, the service hasbeen consolidated. In the past years, musculoskeletal PT-led cl<strong>in</strong>ics and programmes <strong>in</strong> collaboration with Orthopaedicsand Traumatology Department, Accident and Emergency Department, Family Medic<strong>in</strong>e Department and other cl<strong>in</strong>icalpartners were developed and susta<strong>in</strong>ed. In the cluster, Consultant Physiotherapist provided, developed and supportedmusculoskeletal service <strong>in</strong> different hospitals and sett<strong>in</strong>gs, <strong>in</strong>tegrat<strong>in</strong>g service delivery and uphold<strong>in</strong>g standards of care.With the development of new tra<strong>in</strong><strong>in</strong>g opportunities such as work-based tra<strong>in</strong><strong>in</strong>g, advanced specialty tra<strong>in</strong><strong>in</strong>g, e-courseware,corporate overseas scholarships, Consultant Physiotherapist contributed as a team <strong>in</strong> enhanc<strong>in</strong>g people development andstaff competency.As the prevalence of musculoskeletal disorders has been <strong>in</strong>creas<strong>in</strong>g, the extended roles of physiotherapists <strong>in</strong> triage, andmanagement of disorder at primary, secondary and tertiary sett<strong>in</strong>gs are profound. With further development of ConsultantPhysiotherapists <strong>in</strong> other clusters, new horizons of physiotherapy practice <strong>in</strong> the field would be further promulgated.Wednesday, 15 MayPS5.4 New Horizons of Allied Health Practices 16:15 Theatre 2Consultant Physiotherapist <strong>in</strong> Musculoskeletal: Experience Shar<strong>in</strong>g from Pr<strong>in</strong>ce of Wales HospitalYeung AKCPhysiotherapy Department, Pr<strong>in</strong>ce of Wales Hospital, Hong KongBackgroundSpecialisation is a worldwide trend of professional development. A Consultant Physiotherapist is considered to be a valueaddedSenior Physiotherapist with competence <strong>in</strong> musculoskeletal specialisation who provides cl<strong>in</strong>ical leadership, br<strong>in</strong>gsstrategic directions, <strong>in</strong>novations and <strong>in</strong>fluence through cl<strong>in</strong>ical, research and education. New Territories East Clusterconverted three Senior Physiotherapists to Consultant Physiotherapist <strong>in</strong> 2011 with the aim to work towards this strategicvision.Roles Extension/EnhancementIn our experience, conversion from Senior Physiotherapist to Consultant Physiotherapist could dist<strong>in</strong>ct and formalise theconsultancy role <strong>in</strong> musculoskeletal specialty. The role extension and enhancement was accomplished <strong>in</strong> terms of handl<strong>in</strong>ghighly complex musculoskeletal conditions, provid<strong>in</strong>g specialised evidence-based musculoskeletal service, formulat<strong>in</strong>gtra<strong>in</strong><strong>in</strong>g programme, and execut<strong>in</strong>g consultancy role <strong>in</strong> a variety of sett<strong>in</strong>gs and a range of care from preventive, curative,rehabilitative and palliative care service.Service ImpactThrough the provision of consultancy role <strong>in</strong> musculoskeletal specialty, lead<strong>in</strong>g quality and safety projects, accreditationexercise, service remodell<strong>in</strong>g reforms, pilot research, work-based tra<strong>in</strong><strong>in</strong>g projects, seamless programme with familymedic<strong>in</strong>e and management reform project through Lean concept, we are work<strong>in</strong>g towards the Hospital Authority mission andstrategic vision <strong>in</strong> provid<strong>in</strong>g quality and specialised musculoskeletal service and <strong>in</strong>creas<strong>in</strong>g collaboration opportunity withdoctor and other discipl<strong>in</strong>es.ChallengesThere are many challenges faced by the Consultant Physiotherapist <strong>in</strong>clud<strong>in</strong>g organisational and professional acceptance;support and resources allocation by stakeholders and policy makers; and the succession plan to develop the consultant role.Way ForwardThe road was neither straightforward nor without challenges. The further development of Consultant Physiotherapist mayhelp the realisation of Career Progression Model, provid<strong>in</strong>g formal recognition of specialisation and career advancementopportunities. With the mission and vision for better professional development and cl<strong>in</strong>ical excellence, ConsultantPhysiotherapist may progress to other cl<strong>in</strong>ical specialties.
Special TopicsST1.1 Ch<strong>in</strong>a Healthcare 10:45 Theatre 2Hospital Accreditation <strong>in</strong> Ma<strong>in</strong>land Ch<strong>in</strong>a中 國 醫 院 評 審 實 踐 與 思 考ZHOU J 周 軍Department of Medical Service Surveillance and Management, National Health and Family Plann<strong>in</strong>g Commission, The People’sRepublic of Ch<strong>in</strong>a中 華 人 民 共 和 國 國 家 衞 生 和 計 劃 生 育 委 員 會 醫 療 服 務 監 管 司為 加 強 醫 療 機 構 分 級 管 理 , 合 理 配 置 醫 療 資 源 , 促 進 醫 療 質 量 和 醫 療 水 平 的 提 高 , 我 國 從 1989 年 開 始 醫 院 評 審 工 作 。 評 審 工 作促 進 了 三 級 醫 療 服 務 體 系 的 建 立 , 提 升 了 醫 院 的 技 術 水 平 和 診 療 能 力 。 在 評 審 開 展 中 也 存 在 過 度 注 重 硬 件 建 設 、 突 擊 迎 接 評 審 等問 題 。2009 年 , 隨 著 新 醫 改 的 啓 動 , 新 一 輪 醫 院 評 審 工 作 有 序 推 進 , 堅 持 “ 以 病 人 為 中 心 ”, 以 體 現 醫 院 整 體 管 理 理 念 為 原 則 , 以持 續 改 進 醫 療 質 量 與 安 全 為 宗 旨 , 兼 顧 實 用 性 和 操 作 性 , 旨 在 促 進 醫 院 明 確 自 身 定 位 , 加 強 內 涵 建 設 , 促 進 醫 院 實 現 “ 三 個 轉 變 ”和 “ 三 個 提 高 ”。我 們 著 力 構 建 新 的 醫 院 評 審 體 系 。 一 是 制 定 醫 院 評 審 的 標 準 體 系 。 已 發 佈 二 、 三 級 綜 合 醫 院 和 心 血 管 病 、 腫 瘤 、 兒 童 、 婦 產 科 等 9類 專 科 醫 院 共 計 11 個 評 審 標 準 及 9 個 配 套 的 實 施 細 則 。 二 是 打 造 醫 院 評 審 的 方 法 體 系 。 採 用 自 我 評 價 、 社 會 評 價 、 醫 療 信 息 統 計評 價 、 現 場 評 價 4 個 維 度 的 評 價 。 在 現 場 評 價 中 使 用 獨 立 評 審 員 制 度 , 選 用 經 過 培 訓 的 同 質 化 的 評 審 員 , 更 加 全 面 地 、 科 學 、 客 觀地 完 成 對 標 準 的 判 讀 , 找 到 醫 院 存 在 的 問 題 。 三 是 注 重 現 代 信 息 化 手 段 , 建 立 醫 院 評 審 數 據 庫 。 建 立 醫 院 質 量 監 測 評 價 系 統 , 建 立現 場 評 價 結 果 數 據 庫 。 通 過 大 量 的 數 據 , 形 成 醫 院 評 審 的 標 桿 值 , 在 醫 院 中 起 到 標 桿 引 領 作 用 。81HOSPITAL AUTHORITY CONVENTION 2013下 一 步 的 工 作 方 向 , 是 逐 步 完 善 以 病 人 為 中 心 的 醫 院 評 審 體 系 , 不 斷 培 養 專 業 化 的 評 審 員 隊 伍 。 逐 步 建 立 評 價 結 果 公 佈 制 度 , 促 進信 息 公 開 。 構 建 第 三 方 評 價 機 構 , 使 醫 院 評 審 工 作 不 斷 國 際 化 。ST1.2 Ch<strong>in</strong>a Healthcare 10:45 Theatre 2Wednesday, 15 MayThe Position<strong>in</strong>g and Development of Integrated Traditional Ch<strong>in</strong>ese and Western Medic<strong>in</strong>e Hospitals <strong>in</strong>Ma<strong>in</strong>land Ch<strong>in</strong>a內 地 中 西 醫 結 合 醫 院 的 定 位 及 發 展J<strong>in</strong> EC 金 二 澄Department of Medical Adm<strong>in</strong>istration, State Adm<strong>in</strong>istration of Traditional Ch<strong>in</strong>ese Medic<strong>in</strong>e, The People’s Republic of Ch<strong>in</strong>a中 華 人 民 共 和 國 國 家 中 醫 藥 管 理 局 醫 政 司中 西 醫 結 合 醫 院 是 在 中 西 醫 兩 種 理 論 體 系 有 機 結 合 、 逐 步 形 成 新 的 理 論 內 涵 、 研 究 成 果 不 斷 豐 富 的 基 礎 上 逐 步 建 立 發 展 起 來 。 其 臨 床主 要 依 據 中 西 醫 兩 套 醫 學 理 論 體 系 , 努 力 遵 循 中 西 醫 結 合 研 究 的 最 新 成 果 進 行 診 療 活 動 ; 同 時 還 承 擔 著 不 斷 探 索 研 究 和 創 新 完 善 獨 特的 中 西 醫 結 合 新 理 論 、 新 方 法 、 新 技 術 等 重 要 功 能 , 是 納 入 我 國 《 醫 療 機 構 管 理 條 例 》 的 一 種 特 殊 類 別 的 法 定 醫 療 機 構 。30 多 年 來 , 在政 府 的 大 力 宣 導 支 持 、 廣 大 中 西 醫 結 合 工 作 者 的 積 極 探 索 、 社 會 各 界 和 廣 大 患 者 的 關 心 鼓 勵 下 取 得 了 快 速 發 展 , 多 項 研 究 成 果 所 獲 國 際國 內 獎 項 水 準 已 超 越 單 純 的 中 醫 和 西 醫 , 發 展 前 景 非 常 喜 人 。 與 此 同 時 , 目 前 中 西 醫 結 合 醫 院 的 建 設 發 展 水 準 與 其 構 建 中 西 醫 結 合 獨 特理 論 體 系 的 總 體 目 標 和 人 民 群 眾 的 期 望 相 比 , 仍 有 很 大 差 距 , 需 要 在 進 一 步 的 探 索 實 踐 中 不 斷 提 高 , 逐 步 完 善 。
82HOSPITAL AUTHORITY CONVENTION 2013Special TopicsST2.1 Medical Leadership 13:15 Theatre 2Lead<strong>in</strong>g Change <strong>in</strong> Health Systems: The Y<strong>in</strong> and Yang of Medical LeadershipDickson GSchool of Leadership Studies, Royal Roads University, CanadaY<strong>in</strong> and yang complement each other to ma<strong>in</strong>ta<strong>in</strong> cosmic harmony. Healthcare providers all over the world are striv<strong>in</strong>g to f<strong>in</strong>dsuccessful healthcare strategies or models of care to ensure seamless care <strong>in</strong> a susta<strong>in</strong>able healthcare system. As the worldchanges, harmony can be disturbed. It is the role of the medical leader to balance the forces of change both with<strong>in</strong> himselfand his area of responsibility <strong>in</strong> order to serve the needs of the people. In so do<strong>in</strong>g, medical leaders must balance the “science”of care with consideration for the “people” of care. In this session we will explore the tumultuous changes that are impact<strong>in</strong>ghealth systems around the world and <strong>in</strong> Hong Kong, some of the practices that are chang<strong>in</strong>g and must change, and theimplications for medical leaders who must “lead themselves” <strong>in</strong> order to contribute to harmonious system reform.Wednesday, 15 MayST2.2 Medical Leadership 13:15 Theatre 2Delivery Science and the Future of Healthcare LeadershipMulley AGDartmouth Center for Health Care Delivery Science, Dartmouth College, USAAround the globe, healthcare leaders are struggl<strong>in</strong>g to achieve healthcare that is equitable <strong>in</strong> access, efficient <strong>in</strong> production,and effective <strong>in</strong> outcomes valued by those who live with them. These goals will not be achieved without leaders equippedwith the knowledge and skills necessary to apply scientific method to healthcare delivery.Healthcare is to susta<strong>in</strong> or improve people’s health. Research at Dartmouth and elsewhere has shown wide variations <strong>in</strong>many countries <strong>in</strong> delivery rates of specific services and outcomes achieved. Health outcomes <strong>in</strong> high-rate, high-cost regionsare not always better and can be worse.Delivery science draws from eng<strong>in</strong>eer<strong>in</strong>g and management sciences to learn from variation <strong>in</strong> outcomes by exam<strong>in</strong><strong>in</strong>gprocesses to improve outcomes and lower cost. It draws from economics and behavioural sciences to learn how <strong>in</strong>dividualpatients differ <strong>in</strong> the value they associate with different services and outcomes. Together, these approaches support deliveryof the right care to the right people, avoid<strong>in</strong>g harm and waste that consumes 20% to 40% of healthcare expenditures acrossnations.With Mayo Cl<strong>in</strong>ic and Intermounta<strong>in</strong> Health, Dartmouth organised the High Value Healthcare Collaborative (HVHC) to applyhealthcare delivery science to more than 70 million patients <strong>in</strong> the United States. It forms a coalition of delivery sciencecollaboratives <strong>in</strong> other countries <strong>in</strong>clud<strong>in</strong>g the United K<strong>in</strong>gdom and Ch<strong>in</strong>a.Dartmouth has formed a curriculum for a Master’s Degree <strong>in</strong> Health Care Delivery Science that has attracted healthcareleaders from 10 countries <strong>in</strong>clud<strong>in</strong>g Ch<strong>in</strong>a, India and S<strong>in</strong>gapore.The problems of healthcare delivery are universal. There is much to be learned from across contexts and borders with a newgeneration of leaders who are will<strong>in</strong>g and able to embrace delivery science.
Service Priorities and <strong>Programme</strong>s Free Papers83SPP1.1 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221Effectiveness of a Structured Physical Rehabilitation <strong>Programme</strong> for Ch<strong>in</strong>ese Population with DepressiveDisordersChau RMW 1 , Lau PMY 1 , Ng RMK 2 , Tsang AWK 2 , Ng KM 2 , Chan CT 2 , Lam MMY1,Tang FLW 1 , Lo PYK 1 , Lau PWL 11Physiotherapy Department, 2 Department of Psychiatry, Kowloon Hospital, Hong KongIntroductionExercise was found to be effective <strong>in</strong> the management of depressive disorders among western populations. However,studies have shown cultural differences <strong>in</strong> symptoms manifestation of depressive disorders between Ch<strong>in</strong>ese and westernpopulations. Literatures on exercise benefits of Ch<strong>in</strong>ese population are limited.ObjectivesThe aim of this study was to <strong>in</strong>vestigate the effectiveness of a structured Physical Rehabilitation <strong>Programme</strong> on improv<strong>in</strong>g thephysical fitness and negative psychological symptoms for Ch<strong>in</strong>ese population with depressive disorders.MethodologyA s<strong>in</strong>gle-bl<strong>in</strong>d, randomised controlled trial (RCT) was conducted <strong>in</strong> Ch<strong>in</strong>ese adults with depressive disorders. 64 subjectswere recruited from Kowloon Hospital dur<strong>in</strong>g February 2012 to January 2013 with random allocation <strong>in</strong>to two groups: (1)<strong>in</strong>tervention group with 60-m<strong>in</strong>ute structured Physical Rehabilitation <strong>Programme</strong>, three times a week for 12 weeks; or (2)12-week waitlist control group. Physical outcome measures <strong>in</strong>cluded maximum hand-grip and quadriceps power test formeasur<strong>in</strong>g muscle strength; sit-and-reach test for flexibility; one-m<strong>in</strong>ute sit-up count for muscular endurance; maximaloxygen consumption (VO2max) for cardiovascular endurance and Depression, Anxiety, Stress Scale (DASS-21) for mentaloutcome measure. The outcome measures were adm<strong>in</strong>istered by an <strong>in</strong>dependent physiotherapist who was bl<strong>in</strong>d to the groupallocation. Post-<strong>in</strong>tervention satisfaction questionnaire on perceived impact and programme evaluation was also conducted.Wilcoxon signed ranks test and Mann-Whitney U test were used for group comparison after 12 weeks.Results51 subjects (<strong>in</strong>tervention: n=27, control: n=24) with mean age of 46.6±10.8 completed the programme. Basel<strong>in</strong>e characteristicsbetween two groups were comparable. Significant with<strong>in</strong>-group improvement <strong>in</strong> both physical and mental doma<strong>in</strong>s wasfound <strong>in</strong> <strong>in</strong>tervention group (all p
84HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP1.2 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221Development of a Regional Intensive Care Unit (ICU) Database for Longitud<strong>in</strong>al ICU Performance Monitor<strong>in</strong>g:Summary and the Way ForwardCheung LYS 1 , Liu SH 1 , Kung CM 1 , Lai KY 21Quality and Safety Division, Hospital Authority Head Office; 2 Intensive Care Unit, Queen Elizabeth Hospital, Hong KongIntroductionAmong all acute cl<strong>in</strong>ical services provided by the public hospitals under the Hospital Authority (HA), the Intensive CareUnit (ICU) service is the most expensive one. However, to precisely estimate its appropriate service capacity to best meetthe community need is not easy because of the heterogeneity of ICU patients’ severity of illnesses and case mix, and thedifferences across <strong>in</strong>stitutional sett<strong>in</strong>gs.ObjectivesRecognis<strong>in</strong>g the forego<strong>in</strong>g significance, <strong>in</strong> 2007, the Department of Infection, Emergency and Cont<strong>in</strong>gency (IEC) of the HAHead Office started work<strong>in</strong>g with the Coord<strong>in</strong>at<strong>in</strong>g Committee <strong>in</strong> Intensive Care, the so-called COC(ICU), to commission amodel<strong>in</strong>g tool that would be available to all users to aid discussions on the pattern of service delivery.Wednesday, 15 MayMethodologyReferr<strong>in</strong>g to the overseas experience <strong>in</strong> us<strong>in</strong>g risk-adjusted mortality models s<strong>in</strong>ce the 80s, after deliberation <strong>in</strong> variousCOC(ICU) meet<strong>in</strong>gs, the Acute Physiology and Chronic Health Evaluation (APACHE) was chosen as the standard tool forICU outcome prediction and performance assessment. It was one of the ICU risk-adjusted mortality models that usedbasic physiologic pr<strong>in</strong>ciples to categorise ICU patients by their risks of death. Literatures reviewed that the APACHE riskadjustedmortality model was a robust, prospectively validated system useful for comparison of ICU performance withlarge group of patients. With the support from the HO Information Technology Department, an APACHE data entry <strong>in</strong>terfacewith extensive logic and data check was built <strong>in</strong> the HA Cl<strong>in</strong>ical Management System (CMS). The user-friendly prognosticscore report<strong>in</strong>g function ga<strong>in</strong>ed the acceptance of users after the launch of the system. With a two-year budget earmarked<strong>in</strong> 2009, a designated ICU data collection team comprised of designated data collectors was set up to alleviate the ICUfrontl<strong>in</strong>e cl<strong>in</strong>ical staff’s workload <strong>in</strong> data collection and data entry. With comprehensive tra<strong>in</strong><strong>in</strong>g <strong>in</strong> data def<strong>in</strong>ition and dataentry methodology provided to the designated data collectors, five year of ICU APACHE data was collected. The high degreeof data consistency, <strong>in</strong>tra-rater reliability, and <strong>in</strong>ter-rater reliability of the collected data formed a robust foundation whichprovided external benchmark<strong>in</strong>g <strong>in</strong> monitor<strong>in</strong>g variations <strong>in</strong> ICU patient outcomes and changes <strong>in</strong> practice over time.ResultsOverall the HA’s ICU performance was proved to be creditable <strong>in</strong> external benchmark<strong>in</strong>g. The performance fluctuationspotted based on the data collected from 2007 to 2012 was fed back to <strong>in</strong>dividual ICUs and hospital management forrespective exploration and service improvement. To align with the corporate direction to manage different cl<strong>in</strong>ical registryunder the Department of Cl<strong>in</strong>ical Effectiveness and Technology Management (CE&TM), the <strong>in</strong>vestment <strong>in</strong> all aspects of thistype of cl<strong>in</strong>ical performance monitor<strong>in</strong>g programme, rang<strong>in</strong>g from ensur<strong>in</strong>g the quality of data collection and its effective useto address<strong>in</strong>g problems, is believed to be able to susta<strong>in</strong>.
Service Priorities and <strong>Programme</strong>s Free PapersSPP1.3 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221Nurse Initiated Sequential Compression Device Application <strong>Programme</strong> for Total Knee Replacement PatientCheung SS 1 , Hui CY 1, 2 , Wong WK 1, 2 , Cheung YC 1, 2 , Mok LC 1, 2 , Pang WW 1, 21Department of Orthopaedics and Traumatology; 2 A9 Cl<strong>in</strong>ical Admission Ward, Pamela Youde Nethersole Eastern Hospital,Hong KongIntroductionS<strong>in</strong>ce 2010, all patients undergo<strong>in</strong>g total knee replacement (TKR) have put on pharmacological deep venous thrombosis (DVT)prophylaxis <strong>in</strong> Pamela Youde Nethersole Eastern Hospital (PYNEH). However, around 10% of these patients developed DVT<strong>in</strong> PYNEH dur<strong>in</strong>g the year of 2010 and 2011. Evidence showed that Sequential Compression Device (SCD) could be one of thepreferred non-pharmacological methods of thromboprophylaxis for Asian populations with TKR.Objectives(1) To <strong>in</strong>vestigate whether nurse <strong>in</strong>itiated SCD application programme could reduce the <strong>in</strong>cidence of post-TKR DVT; and (2) to<strong>in</strong>vestigate patients’ level of acceptance on the usage of SCD dur<strong>in</strong>g hospitalisation.85HOSPITAL AUTHORITY CONVENTION 2013MethodologyPhase 1: All elective TKR female patients with Autar DVT risk score greater than 15 were selected. SCD with knee lengthsleeves were then applied to both legs upon transferred from surgery. The regime was ma<strong>in</strong>ta<strong>in</strong>ed until patient resumedself ambulation. A questionnaire was used to collect data on patient’s level of acceptance on the programme. Phase 2: Allelective TKR female and male patients were <strong>in</strong>cluded regardless of the Autar DVT risk score. Patients who did not sufferfrom DVT upon the first follow-up (around one week) after discharge was considered as “No postoperative DVT” <strong>in</strong> thisprogramme.ResultsFrom October 2011 to January 2013, 140 patients were studied. In Phase 1, 49 patients were recruited and the DVT rate was4.1%. In Phase 2, 91 patients were recruited and none of them developed DVT. Therefore, the overall DVT rate was only 1.4%.The duration of SCD usage among the studied patients ranged from three to 16 days. Around 90% of them were satisfiedand accepted the usage of SCD.ConclusionIn view of patients’ acceptance, f<strong>in</strong>ancial and cl<strong>in</strong>ical consideration, double prophylaxis (pharmacological and mechanical)was recommended as a means of thromboprophylaxis <strong>in</strong> this group of patients.Wednesday, 15 May
86HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP1.4 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221The Outcomes of Ambulatory Electrocardiography (AECG or Holter) Performed for Patients with SymptomsRelated to Cardiac Arrhythmia <strong>in</strong> the Primary Care: A Case Series ReportChiang LK, Ng LFamily Medic<strong>in</strong>e and General Outpatient Department, Kwong Wah Hospital, Hong KongIntroductionAmbulatory electrocardiography (AECG or Holter) is a dedicated portable recorder which provides cont<strong>in</strong>uous records onECG dur<strong>in</strong>g a prolonged period, usually 24 hours. It provides diagnosis of transient disturbances of cardiac rhythm andconduction. The use of Holter <strong>in</strong> primary care sett<strong>in</strong>g aims at early detection of possible life-threaten<strong>in</strong>g cardiac arrhythmia. Itcan m<strong>in</strong>imise the risk by shorten<strong>in</strong>g diagnosis time and provide appropriate early referral to specialist care.Objectives(1) To exam<strong>in</strong>e the present<strong>in</strong>g symptoms of patients <strong>in</strong>dicated for Holter monitor<strong>in</strong>g <strong>in</strong> primary care sett<strong>in</strong>g; (2) to review theoutcomes of Holters monitor<strong>in</strong>g; and (3) to <strong>in</strong>vestigate the predict<strong>in</strong>g patient characteristics for significant Holter outcomes.MethodologyCase studies <strong>in</strong>volved all Holter monitor<strong>in</strong>g done for patients <strong>in</strong> primary care sett<strong>in</strong>g from January 2010 to December 2012.The present<strong>in</strong>g symptoms of patients for Holter monitor<strong>in</strong>g were stratified. Outcomes of Holters and cl<strong>in</strong>ical managementwere analysed.Wednesday, 15 MayResultsDur<strong>in</strong>g the period, Holter mo<strong>in</strong>tior<strong>in</strong>g were <strong>in</strong>dicated for 65 male and 155 female patients, with mean (standard deviation) ageof 64.8 (15.4) and 58.1 (14.1) years old respectively. 63% of them had new symptom; 37% of them had no associated majorcomorbidity; 180 (82%), 11 (5%), four (2%), six (3%) and 19 (8%) cases were <strong>in</strong>dicated for “palpitation”, “dizz<strong>in</strong>ess”, “syncope(presyncope)”, “comb<strong>in</strong>ed symptoms” and “others” respectively. 88 cases (40%) of Holter had significant cardiac arrhythmiaand all patients were referred to Medical Department for further management. The five lead<strong>in</strong>g f<strong>in</strong>d<strong>in</strong>gs were frequentsupraventricular/ventricular ectopics (25%), long QT syndrome (15%), supraventricular/ventricular ectopics <strong>in</strong> bigem<strong>in</strong>y ortrigem<strong>in</strong>y (15%), paroxysmal atrial fibrillation (14%) and paroxysmal supraventricular trachycardia (10%) respectively. 109cases, <strong>in</strong>clud<strong>in</strong>g 27 male and 82 female patients were <strong>in</strong>vestigated for newly onset palpitation. 38% of patients enjoyed goodpast health. 37 cases (34%) had significant cardiac arrhythmia. The five lead<strong>in</strong>g f<strong>in</strong>d<strong>in</strong>gs were frequent supraventricular/ventricular ectopics (22%), supraventricular/ventricular ectopics <strong>in</strong> bigem<strong>in</strong>y or trigem<strong>in</strong>y (19%), paroxysmal supraventriculartrachycardia (19%), paroxysmal atrial fibrillation (14%) and long QT syndrome (11%) respectively.Conclusion40% of Holter monitor<strong>in</strong>g for patients <strong>in</strong> the primary care sett<strong>in</strong>g had significant cardiac arrhythmia who needed referralto specialist for further management. For patients with newly onset palpitation <strong>in</strong> primary care sett<strong>in</strong>g, 34% of them hadsignificant cardiac arrhythmia.
Service Priorities and <strong>Programme</strong>s Free PapersSPP1.5 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221Impact on Further Utilisation of Hospital Services Among Discharged Frail Elders — An Evaluation of IntegratedCare and Discharge Support Service <strong>in</strong> Kowloon Central ClusterMak YF 1 , Chan LT 1 , Chui ESM 2 , Lui NTC 2 , Ngai JSC 2 , Kwan SY 2 , Leung KF 3 , Lau PMY 4 , Li PCK1 , Cheung H 51Department of Medic<strong>in</strong>e, Queen Elizabeth Hospital,2Central Nurs<strong>in</strong>g Division, Kowloon Hospital,3Physiotherapy Department, Queen Elizabeth Hospital,4Occupational Therapy Department, Queen Elizabeth Hospital,5Hospital Chief Executive Office, Kowloon Hospital,Hong KongIntroductionEmergency department visits and readmissions are common after hospital discharge. The Integrated Care and DischargeSupport (ICDS) service was established <strong>in</strong> Kowloon Central Cluster <strong>in</strong> October 2011 to provide seamless multi-discipl<strong>in</strong>arysupport for older patients at risk of readmissions. Patients are followed-up from acute to extended care sett<strong>in</strong>g till eight to 12weeks after they are discharged back to community.87HOSPITAL AUTHORITY CONVENTION 2013Objectives(1) To study the routes of hospital services utilisation of older patients after hospitalisation; and (2) to evaluate the impact ofICDS which targets high risk elders (mostly with HARRPE score ≥0.2, i.e. predicted 20% unplanned readmissions rate [28-days]).MethodologyA retrospective analysis was conducted on all medical patients admitted to Queen Elizabeth Hospital and ICDS clientsaged ≥60 years from 1 October 2011 to 30 September 2012. Comparisons were made for events with respect to three timeframes: 28-day, 90-day and 180-day (events pre-hospital admission vs events post discharge). The events studied <strong>in</strong>clude: (1)Emergency Department (AED) attendance rate; (2) medical admission rate; (3) hospital length of stay (LOS). Paired t test wasused for the analysis with p
88Service Priorities and <strong>Programme</strong>s Free PapersHOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 MaySPP1.6 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221Multi-modal Strategy for Improv<strong>in</strong>g Hand Hygiene Compliance In Intensive Care UnitNg WYG 1 , Leung PWR 1 , Luk HW 1 , Lai KY 1 , Lee SYS 2 , Tsang NCD 21Intensive Care Unit, 2 Department of Microbiology, Queen Elizabeth Hospital, Hong KongIntroductionHand hygiene has been considered the s<strong>in</strong>gle most important measure to prevent nosocomial <strong>in</strong>fections. However, thecompliance <strong>in</strong> <strong>in</strong>tensive care unit (ICU) was poor. A serious improvement strategy was needed. S<strong>in</strong>ce the second half of2010, we have adopted a multi-modal campaign to improve our hand hygiene compliance (HHC).Objectives(1) To improve HHC by us<strong>in</strong>g multi-modal campaign; and (2) to develop strategy that can susta<strong>in</strong> HHC.MethodologyWe monitored the HHC accord<strong>in</strong>g to the method proposed by the World Health Organisation before and after theimplementation of our strategy: The five moments for hand hygiene. The improvement strategy had started s<strong>in</strong>ce the secondhalf of 2010. The strategy was multi-modal: (1) Easy access to wash<strong>in</strong>g facilities by putt<strong>in</strong>g alcohol hand rubs at bedsidesand room entrances; (2) role model<strong>in</strong>g by senior staff to motivate all ICU staff to comply with hand hygiene measures; (3)observation and feedback — from the second half of 2010, 41 ICU staff were tra<strong>in</strong>ed to be validated observers for directobservation of staff’s HHC with a structural and standardised protocol. They also provided real-time correction andfeedback to our staff on proper hand hygiene practice. ICU <strong>in</strong>ternal HHC monitor<strong>in</strong>g report was prepared every two monthsby ICU adm<strong>in</strong>istrative staff. Hospital <strong>in</strong>fection control team provided external HHC monitor<strong>in</strong>g every quarter of a year. Boththe <strong>in</strong>ternal and external HHC monitor<strong>in</strong>g reports were posted up at ICU staff notice boards for self-monitor<strong>in</strong>g and selfre<strong>in</strong>forcement;and (4) education — proper hand hygiene became an essential topic <strong>in</strong> ICU orientation tra<strong>in</strong><strong>in</strong>g programme.ResultsThe overall HHC rate dramatically <strong>in</strong>creased from 38.5% <strong>in</strong> the first half of 2010, to 64% (by <strong>in</strong>ternal monitor<strong>in</strong>g), and 67.9%(by external monitor<strong>in</strong>g) <strong>in</strong> the second half of 2010. The compliance rate rema<strong>in</strong>ed static afterwards, with <strong>in</strong>ternal monitor<strong>in</strong>gcompliance rate of 62.7%, and 67.1% <strong>in</strong> 2011 and 2012 respectively, and external monitor<strong>in</strong>g compliance rate of 70.0% and76.0% <strong>in</strong> 2011 and 2012 respectively. The multi-modal hand hygiene improvement strategy effectively improved hand hygienecompliance <strong>in</strong> our ICU. More importantly, it susta<strong>in</strong>ed the improvement <strong>in</strong> overall hand hygiene compliance.
Service Priorities and <strong>Programme</strong>s Free Papers89SPP1.7 Enhanc<strong>in</strong>g Healthcare Delivery 10:45 Room 221Optimis<strong>in</strong>g Patient Flow as a Way of Improv<strong>in</strong>g Health Service <strong>in</strong> a Low Risk Obstetric Cl<strong>in</strong>icOng CYT, Cheng M, Lee CP, Chung SM, Tse WY, Choi A, Ho LFDepartment of Obstetrics and Gynaecology, Queen Mary Hospital, Hong KongIntroductionLong wait<strong>in</strong>g time <strong>in</strong> outpatient cl<strong>in</strong>ic is a common compla<strong>in</strong>t that has posed a substantial challenge to the healthcaresystem. Patient flow <strong>in</strong> the low risk obstetric cl<strong>in</strong>ic <strong>in</strong> Queen Mary Hospital (QMH) was identified as target for improvement.ObjectivesTo reduce patients’ wait<strong>in</strong>g time dur<strong>in</strong>g cl<strong>in</strong>ic visit.MethodologyIn order to exam<strong>in</strong>e the total wait<strong>in</strong>g time <strong>in</strong> the low risk obstetric cl<strong>in</strong>ic <strong>in</strong> QMH, we have <strong>in</strong>volved cl<strong>in</strong>ical and frontl<strong>in</strong>eoperational staff to map out the patient journey (from time of arrival for registration to time of leav<strong>in</strong>g) and associatedprocesses as a work<strong>in</strong>g group. The core work<strong>in</strong>g group consists of consultant, resident, department operations manager,ward manager, advanced practise nurse and midwife. Three surveys were done to measure the total patients’ wait<strong>in</strong>g time.The first survey was conducted for one week <strong>in</strong> August 2012 (Group 1), that was the pre-implementation of changes. Four tofive patients were randomly selected <strong>in</strong> four different time slots dur<strong>in</strong>g each cl<strong>in</strong>ic session. The total wait<strong>in</strong>g time was 110.5± 36.1 m<strong>in</strong>utes (mean ± SD) and the wait<strong>in</strong>g time for consultation was 67.0 ± 32.8 m<strong>in</strong>utes (mean ± SD). Every wait<strong>in</strong>g time<strong>in</strong>terval and associated processes were exam<strong>in</strong>ed to identify gaps for improvement by us<strong>in</strong>g the lean th<strong>in</strong>k<strong>in</strong>g and theory ofconstra<strong>in</strong>ts. Possible factors were addressed <strong>in</strong>clud<strong>in</strong>g long toilet queue for ur<strong>in</strong>e storage, late start of doctor consultation,<strong>in</strong>efficient procedure explanations, and midwifery check of records after doctor consultation. Two surveys were conducted <strong>in</strong>November 2012 (Group 2) and January 2013 (Group 3) after staged implementation of changes.Results167 patients were surveyed with 63, 58 and 46 from Group 1, 2 and 3 respectively. Wait<strong>in</strong>g time for ur<strong>in</strong>e tests and bloodpressure measurements was the lowest <strong>in</strong> Group 2, with a slight <strong>in</strong>crease <strong>in</strong> Group 3, which was still significantly shorterthan Group 1 (p=0.000). Wait<strong>in</strong>g time for consultation was significantly reduced (p=0.0004). Wait<strong>in</strong>g time for nurse <strong>in</strong>struction(p=0.4) showed no statistical difference. The total wait<strong>in</strong>g time was significantly reduced (p=0.0000), and the shortest <strong>in</strong>Group 3 (74.6 m<strong>in</strong>utes). The results showed that the total wait<strong>in</strong>g time was reduced by 32.5% after staged implementationof changes advocated by an enthusiastic group. Optimis<strong>in</strong>g patient flow as a way of improv<strong>in</strong>g health service <strong>in</strong> a low riskobstetric cl<strong>in</strong>ic is mission possible.HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
90HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP2.1 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221Achiev<strong>in</strong>g Susta<strong>in</strong>able and Significant Reduction <strong>in</strong> Methicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA)Bacteremia Rates Over Five Years <strong>in</strong> a Major Acute General Hospital: A Multi-level Strategic ApproachLam BHS 1 , Lam SS 2 , Lee WM 2 , Ng TK1, 21Department of Pathology (Microbiology), 2 Infection Control Team, Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionMethicill<strong>in</strong>-resistant Staphylococcus aureus (MRSA) bacteremia can cause high mortality and morbidity, and is associated withthe upsurge of patient care cost. Yet most of the episodes, especially those acquired <strong>in</strong> the hospital, could be preventable.With the engagement of all stakeholders, tailor-made programmes for targeted departments have been designed and rolledout from 2008.ObjectivesTo reduce the number of MRSA bacteremia episodes per year, the MRSA bacteremia rates, especially those <strong>in</strong>travascularcatheter-related bloodstream <strong>in</strong>fections (CRBSI) and hospital-apportioned ones (i.e. detected after 48 hours of admission)progressively.Wednesday, 15 MayMethodology(1) Laboratory test<strong>in</strong>g and report<strong>in</strong>g: (a) Use of chromogenic agar for MRSA to facilitate early detection; (b) additionaltest<strong>in</strong>g on vancomyc<strong>in</strong> m<strong>in</strong>imum <strong>in</strong>hibitory concentration <strong>in</strong> selective cases to guide appropriate treatment on prevention ofbacteremic complication. (2) Surveillance: Set up hospital-based surveillance, together with the corporate surveillance, tomonitor MRSA case load, <strong>in</strong>clud<strong>in</strong>g carriage, <strong>in</strong>fections with or without bacteremia, and CRBSI of different wards and units.From detailed case review, source of every case of MRSA bacteremia was identified and gaps analysed. Trends were fedback regularly to stakeholders for necessary actions. (3) Patient care: (a) Different tailor-made active screen<strong>in</strong>g programmeswith or without decolonisation protocols <strong>in</strong> ICU, Renal, Respiratory, Hematology units, Neurosurgery and RehabilitationBlock; (b) 2% chlorhexid<strong>in</strong>e bath<strong>in</strong>g for MRSA carriers or aged homes patients <strong>in</strong> medical and oncology departments; (c)hospital-wide CRBSI prevention programme adopt<strong>in</strong>g standardised central l<strong>in</strong>e <strong>in</strong>sertion and care bundle s<strong>in</strong>ce 2010; (d)hand hygiene campaigns to improve staff compliance; (e) use of chlorhexid<strong>in</strong>e antiseptic kits for blood culture tak<strong>in</strong>g tom<strong>in</strong>imise contam<strong>in</strong>ation. (4) Compliance of contact isolation and environmental hygiene was regularly monitored and ad hocspot checked with adenos<strong>in</strong>e triphosphate (ATP) biolum<strong>in</strong>escence and fluorescent markers.ResultsFrom 2007 to 2012, MRSA bacteremia episodes per year dropped from 66 to 33 (50% reduction), with rates from 0.20to 0.09/1,000 patient days (55% reduction) for acute beds, while the number of hospital-apportioned MRSA bacteremiaepisodes per year dropped from 38 to 21 (45% reduction), with rates from 0.11 to 0.06/1,000 patient days (45% reduction) foracute beds. The number of CRBSI episodes caused by MRSA dropped from 13 <strong>in</strong> 2010 to four <strong>in</strong> 2011, f<strong>in</strong>ally to one only <strong>in</strong>2012 (92% reduction).ConclusionsThe multi-level strategic approach with engagement of all stakeholders, robust surveillance system and laboratory supportwas highly effective <strong>in</strong> achiev<strong>in</strong>g susta<strong>in</strong>able reduction <strong>in</strong> MRSA bacteremia rates.
Service Priorities and <strong>Programme</strong>s Free PapersSPP2.2 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221Enhancement <strong>Programme</strong> on Quality Care Integrated with Life Education Workshop for Healthcare Assistants(HCAs)Liu SY 1 , Wong N 1 , Lee CY 1 , Lau KY 2 , Lam WS 2 , Chow YH 1 , Chung KF 31Geriatric and Rehabilitation Service, 2 Pulmonary and Palliative Care Service, Department of Medic<strong>in</strong>e,3Nurs<strong>in</strong>g Service Division, Haven of Hope Hospital, Hong KongIntroductionAccord<strong>in</strong>g to a survey on 104 Healtcare Assistants (HCAs) <strong>in</strong> Haven of Hope Hospital <strong>in</strong> December 2012, 89% of themhave stress from work, and about 30% have less than two years work<strong>in</strong>g experience. It was one of the imperatives of theprogramme to uphold the provision of quality care by <strong>in</strong>creas<strong>in</strong>g productivity, staff engagement and well-be<strong>in</strong>g. An one andhalf day, tailor-made enhancement programme was launched to empower HCAs with necessary knowledge, skill and attitude<strong>in</strong> assist<strong>in</strong>g quality nurs<strong>in</strong>g care. This programme was developed by nurs<strong>in</strong>g staff from different services of Haven of HopeHospital, and the life education workshop was a collaborative effort with Haven of Hope Christian Service.Objectives(1) To enhance staff <strong>in</strong> develop<strong>in</strong>g appropriate attitude, skill and knowledge at work; (2) to provide tra<strong>in</strong><strong>in</strong>g on communicationskills and conflict management; (3) to promote team build<strong>in</strong>g <strong>in</strong> l<strong>in</strong>e with the hospital’s core values and missions; (4) to ensurestandardisation and optimise productivity of quality care; and (5) to <strong>in</strong>spire HCAs by look<strong>in</strong>g <strong>in</strong>to their own “life journey” withenhancement of sense of well-be<strong>in</strong>g.91HOSPITAL AUTHORITY CONVENTION 2013MethodologyA pre-programme survey was conducted to arouse HCA’s self-awareness of attitude, skill and knowledge at work. Apost-programme questionnaire was analysed. A quiz consist<strong>in</strong>g of 10 multiple-choices was used as an assessment andre<strong>in</strong>forcement of the knowledge and skill learned.ResultsThe prelim<strong>in</strong>ary outcomes were measured after 52 HCAs completed the programme. Post-programme questionnairerevealed that (1) 100% of participants were more confident to handle their daily work; (2) 99.4% of participants had moreunderstand<strong>in</strong>g on their role and felt that their values were respected; and (3) they all passed the quiz on nurs<strong>in</strong>g knowledge.A hand<strong>book</strong> for HCAs <strong>in</strong> assist<strong>in</strong>g nurs<strong>in</strong>g care was standardised and used as a record for cont<strong>in</strong>uous monitor<strong>in</strong>g of theirperformance.ConclusionsMajority of HCAs reflected their positive attitude towards the programme <strong>in</strong> terms of usefulness and mean<strong>in</strong>gfulness for theirwork. It was a good opportunity for HCAs to look <strong>in</strong>to their own well-be<strong>in</strong>g, and it served as a platform for HCAs to expresstheir feel<strong>in</strong>gs and their contributions have been recognised.Wednesday, 15 May
92HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP2.3 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221Multi-discipl<strong>in</strong>ary Home Mechanical Ventilation (HMV) <strong>Programme</strong> for Patients with Neuromuscular Diseases(NMD) <strong>in</strong> Queen Elizabeth Hospital (QEH)Ng CK 1 , O WH 1 , Lit MPK 1 , Lee KH 1 , Chan HF 2 , Chan YC 2 , Cheung YF 2 , Hui YT 3 , Chu S1, 4 , Chong HM 5 , Yu David 6 , Chan JHM2and Chan JWM 11Division of Respiratory Medic<strong>in</strong>e, Department of Medic<strong>in</strong>e, 2 Division of Neurology, Department of Medic<strong>in</strong>e,3Division of Gastroenterology, Department of Medic<strong>in</strong>e, 4 Dvision of Palliative Care, Department of Medic<strong>in</strong>e,5Department of Ear, Nose and Throat, 6 Physiotherpay Department, Queen Elizabeth Hospital, Hong KongIntroductionPatients with neuromuscular disease (NMD) would develop respiratory failure and require assisted ventilation at term<strong>in</strong>alstages. To achieve coord<strong>in</strong>ated effort, a multi-discipl<strong>in</strong>ary Home Mechnical Ventilation (HMV) programme <strong>in</strong>volv<strong>in</strong>gpulmonologists, neurologists, palliative care physicians, gastroenterologists, ear, nose and throat surgeons, respiratorynurses and physiotherapists was launched <strong>in</strong> 2007. The programme aimed to: (1) reduce unplanned <strong>in</strong>tubations with earlierapplication of non-<strong>in</strong>vasive ventilation if <strong>in</strong>dicated; (2) monitor disease progress regularly; (3) evaluate, assist and preparepatients and carers for HMV before onset of respiratory failure; (4) provide advance care plann<strong>in</strong>g and palliative care ifnecessary; and (5) assessment of tracheostomy and feed<strong>in</strong>g.ObjectivesTo describe the roles of the team and evaluate the impact of HMV programme on important cl<strong>in</strong>ical outcomes.Wednesday, 15 MayMethodologyAll patients recruited prospectively to the programme s<strong>in</strong>ce 2007 were <strong>in</strong>cluded. Data were retrieved from hospital recordsand analysed with SPSS software 19.0.Results39 NMD patients attended the HMV programme, with mean age of 56.1±16.6 and 61.5% be<strong>in</strong>g males. 20 patients (51.3%)were ventilated at the time of analysis, with 12 (30.8%) already ventilated before programme launched. The number ofunplanned <strong>in</strong>tubations before and after programme launched was 12 (100%) vs four (50%) (p=0.014). Amongst the 10<strong>in</strong>vasively ventilated (T-IPPV) patients, seven (77.8%) were ventilated before and three (27.3%) after the programme launched(p=0.07). The crude mortality rate was 53.8% and pneumonia/respiratory failure accounted for 76.2% of all causes. Themedian survival rate was 31.5 (IQR 16.4-84.7) months <strong>in</strong> the ventilated group compared to 4.6 (2.8-11.9) months <strong>in</strong> thenon-ventilated group (p=0.005). Complications associated with HMV were m<strong>in</strong>or and mostly related to face masks (20%)or tracheostomy wound (25%). Admission rate was still significant, with 14 (70%) patients of chest <strong>in</strong>fections requiredhospitalisations. To prevent aspiration and provide nutritional support, percutaneous endoscopic gastrostomy feed<strong>in</strong>g wassuccessfully <strong>in</strong>itiated <strong>in</strong> 14 (70%) of the ventilated patients by gastroenterologist. Prim<strong>in</strong>g and education on HMV were offeredto all patients by pulmonologists and respiratory nurses. 11 (28.2%) patients opted for no HMV s<strong>in</strong>ce programme launched,and were referred to palliative care team for conjo<strong>in</strong>t management. The multi-discipl<strong>in</strong>ary HMV programme significantlyreduced unplanned <strong>in</strong>tubations and <strong>in</strong>vasive ventilation, and improved survival rate <strong>in</strong> the ventilated group.
Service Priorities and <strong>Programme</strong>s Free PapersSPP2.4 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221Collaborative Multi-discipl<strong>in</strong>ary Approach to Enhance Quality Care for Chronic Obstructive Pulmonary Disease(COPD) Patients <strong>in</strong> Primary CareNg L 1 , Chiang LK 1 , Fung L 2 , Tang R 2 , Siu C 2 , Lau YC 21Family Medic<strong>in</strong>e and General Outpatient Department, 2 Physiotherapy Department, Kwong Wah Hospital, Hong KongIntroductionGlobal Burden of Disease Study from the World Health Organisation (WHO) states that chronic obstructive pulmonarydisease (COPD) is common, and is one of the lead<strong>in</strong>g causes of disability worldwide. In Hong Kong, COPD is the fifth lead<strong>in</strong>gcause of death. Exercise <strong>in</strong>terventions have been shown to be effective <strong>in</strong> improv<strong>in</strong>g exercise tolerance, reduc<strong>in</strong>g shortnessof breath and <strong>in</strong>creas<strong>in</strong>g self efficacy of patients with COPD. Thus, a multi-discipl<strong>in</strong>ary pulmonary rehabilitation programmefocused on patient empowerment and exercise <strong>in</strong>tervention was conducted <strong>in</strong> primary care sett<strong>in</strong>g to enhance the care ofCOPD patients.Objectives(1) To enhance quality care for COPD patients <strong>in</strong> primary care sett<strong>in</strong>g; and (2) to empower self management capability andtechnique of COPD care.93HOSPITAL AUTHORITY CONVENTION 2013MethodologyA prospective study of 192 cl<strong>in</strong>ically diagnosed COPD patients with basel<strong>in</strong>e spirometry +/- bronchodilator test was carriedout from January 2011 to September 2012 <strong>in</strong> a primary care cl<strong>in</strong>ic <strong>in</strong> Hong Kong. 138 COPD subjects participated <strong>in</strong> twosessions per week for a six-week course of pulmonary rehabilitation, which consisted of patient education, smok<strong>in</strong>gcessation counsel<strong>in</strong>g, respiratory muscle tra<strong>in</strong><strong>in</strong>g, physical recondition<strong>in</strong>g, exercise <strong>in</strong>tervention <strong>in</strong>clud<strong>in</strong>g Tai Chi and<strong>in</strong>dividual goal sett<strong>in</strong>g. It also focused on empower<strong>in</strong>g patients’ self management capability and technique <strong>in</strong> COPD control.Patients’ exercise adherence was facilitated through practical experience and self-efficacy enhancement. Pre- and postassessmenttools <strong>in</strong>clud<strong>in</strong>g spirometry, six m<strong>in</strong>utes walk<strong>in</strong>g test (6MWT), COPD self-efficacy ( CSES-Chi), self-efficacy formanag<strong>in</strong>g shortness of breath (SEMSOB) and St. George Respiratory questionnaire (SGRQ) were done.Results124 male and 14 female COPD patients, with mean (standard deviation) age of 74.2 (6.53) years old had completed theprogramme, and the follow-up evaluation was done at the second and the sixth month. 24.6% of them were active smokers.The stages of COPD were 21% mild, 42.8% moderate, 29% severe and 7.2% very severe respectively. FEV1 at pre-, thesecond and the sixth month post-assessment were 1.17 +/- 0.44, 1.30 +/- 0.54 and 1.28 +/- 0.52 L/m<strong>in</strong> respectively. Six MWTat pre-, the second and the sixth month post assessment were 320 +/- 89, 348 +/- 73 and 344 +/- 73 M respectively. Ch<strong>in</strong>eseversion of SGRQ (total) at pre-, the second and the sixth month post-assessment were 32.8 +/- 19.1, 26.8 +/- 16.8 and 26.2+/- 18.1 respectively. CSES-Chi at pre-, the second and the sixth month post-assessment were 0.667 +/- 0.158, 0.698 +/-0.145 and 0.732 +/- 0.127 respectively. The pre- and post-assessment at the second and the sixth month showed statisticallysignificant improvement <strong>in</strong> all outcome measures us<strong>in</strong>g paired t-test. 14 (41.2%) of active smokers successfully quittedsmok<strong>in</strong>g at the sixth month follow-up assessment.Wednesday, 15 May
94HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP2.5 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221A Life Review Project for Term<strong>in</strong>ally Ill Palliative Care Patients Under Care of Cl<strong>in</strong>ical Oncology DepartmentShiu CKS, Lum MYA, Chan MFMDepartment of Cl<strong>in</strong>ical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong KongIntroductionIt is a big challenge for palliative care workers to manage patients who have remorse towards poor relationship with familiesand sometimes unhappy even pa<strong>in</strong>ful memories at their end stage of life. Life review is considered a useful therapeutic<strong>in</strong>tervention to resolve relationship conflicts, aim<strong>in</strong>g to relieve emotional stress of patients and families. Life review is donefor the term<strong>in</strong>ally ill patients by social workers and palliative care nurses <strong>in</strong> the Oncology Department at Pamela YoudeNethersole Eastern Hospital (PYNEH). Tra<strong>in</strong>ed volunteers are also engaged <strong>in</strong> the <strong>in</strong>terventional process. The outcome of thelife review <strong>in</strong>tervention is evaluated for future service plann<strong>in</strong>g.Objectives(1) To provide a structured framework for palliative care workers to practise life review; and (2) to provide Intervention toenhance healthy griev<strong>in</strong>g of patients/families towards end of life.Wednesday, 15 MayMethodologyIn 2012, 30 patients and their family members under PYNEH palliative care services were <strong>in</strong>vited to jo<strong>in</strong> the project. Individual<strong>in</strong>terview was conducted to collect <strong>in</strong>formation for the life review. 15 patients/families of the group were supported toproduce a personalised life <strong>book</strong> and life video by the team. While the other 15 patients, who were very ill, were assisted tohold structured life review at bedside. Feedback from patients/relatives and staff were collected for review.Results(1) Patients and families, <strong>in</strong> general, agreed that life review brought new <strong>in</strong>sight and mean<strong>in</strong>g to them regard<strong>in</strong>g relationshipand achievement. They believed that they had less/no regret towards end of life after life review. (2) Palliative care workersconsidered the structured framework was well developed. They felt that they were competent to perform life review forpatients/families after tra<strong>in</strong><strong>in</strong>g. Formalised tra<strong>in</strong><strong>in</strong>g for all new jo<strong>in</strong>ed palliative care workers is highly recommended.
Service Priorities and <strong>Programme</strong>s Free Papers95SPP2.6 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221Multi-discipl<strong>in</strong>ary Input for Discharge Management <strong>in</strong> Hong Kong Buddhist Hospital (HKBH)Tam KF 1 , Leung MH 2 , Ng P 1 , Lee L 3 , Chuk SL 3 , Pi M 3 , Chan A 4 , Yiu YM 5 , Lee A 6 , Chan S 3 , Lam J 7 , Cheuk T 81Department of Medic<strong>in</strong>e, Hong Kong Buddhist Hospital, 2 Department of Medic<strong>in</strong>e, Queen Elizabeth Hospital, 3 Central Nurs<strong>in</strong>gDivision, Hong Kong Buddhist Hospital, 4 Physiotherapy Department, Hong Kong Buddhist Hospital, 5 Occupational TherapyDepartment, Hong Kong Buddhist Hospital, 6 Medical Social Service Department, Hong Kong Buddhist Hospital, 7 Strategy andPlann<strong>in</strong>g Office, Kowloon Central Cluster, 8 Hong Kong Buddhist HospitalIntroductionPatients hav<strong>in</strong>g complex discharge needs could lead to unnecessary long stay <strong>in</strong> hospital. The ma<strong>in</strong> reasons <strong>in</strong>cluderesistance from patients and/or relatives, and social and f<strong>in</strong>ancial problems. Discharge plann<strong>in</strong>g could reduce avoidable longstay and facilitate timely discharge when patients are medically fit.ObjectivesWith reference to head office circular (2009) on “Long-stay Patient Discharge Management”, Multi-discipl<strong>in</strong>ary DischargeManagement Meet<strong>in</strong>g (MDMM) was set up <strong>in</strong> the Medical Department of Hong Kong Buddhist Hospital (HKBH) <strong>in</strong> July 2012.Major components <strong>in</strong>clude: (1) Weekly 30-m<strong>in</strong>ute meet<strong>in</strong>g MDMM; (2) multi-discipl<strong>in</strong>ary <strong>in</strong>put (doctor, nurse, occupationaltherapist, physiotherapist, and social worker) supported by senior physicians; (3) every long-stay patients with length ofstay (LOS) 30 days as the focus — special mark<strong>in</strong>g <strong>in</strong> ward <strong>in</strong>formation board to enhance visual effect; (4) advice anddirection offered on top of usual medical care; and (5) special measures for difficult cases: (a) discharge date set withfocused <strong>in</strong>terventions; (b) family case conference; (c) department formal letter to <strong>in</strong>form relatives the discharge date; and (d)guardianship application as last resort.MethodologyAn atmosphere of hightened awareness of discharge plann<strong>in</strong>g was created. Frontl<strong>in</strong>e colleagues were supported by multidiscipl<strong>in</strong>aryteam and medical department <strong>in</strong> the discharge plann<strong>in</strong>g, especially <strong>in</strong> difficult cases.ResultsFrom July to December 2012, 108 patients with LOS 30 days were reviewed by MDMM. 44% of them had dischargeproblems (other than medical reasons). 83% of them were discharged successfully after the first or second meet<strong>in</strong>g.Weekly MDMM achieved 46% reduction <strong>in</strong> number of long-stay patients after <strong>in</strong>tervention (July to December 2012, monthlyaverage=15.5) when compared with pre-<strong>in</strong>tervention period (January to June 2012, monthly average=28.7). There wasstatistically significant reduction (p=0.014, Mann-Whitney U test) <strong>in</strong> average LOS (ALOS) after <strong>in</strong>tervention (July to December2012, median ALOS of 12.5 days) when compared with pre-<strong>in</strong>tervention period (January 2011 to June 2012, median ALOS of15.6 days), which was equivalent to 20 extra beds added to service every day.HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
96HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP2.7 Consolidat<strong>in</strong>g Service Providers 13:15 Room 221Evaluation of the Oncology Pharmacists’ Therapeutic Recommendations <strong>in</strong> the Oncology Wards and Cl<strong>in</strong>ics atPr<strong>in</strong>cess Margaret HospitalYip EYT 2 , Yao R 2 , Yau CC 1 , Cheng A 1 , Tsang J 21Oncology Department, 2 Pharmacy Department, Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionA pilot Oncology Pharmacy Service was launched <strong>in</strong> the Oncology Department at Pr<strong>in</strong>cess Margaret Hospital <strong>in</strong> September2010. The oncology pharmacists were responsible for review<strong>in</strong>g patients’ prescriptions, identify<strong>in</strong>g drug-related problems(DRPs) and propos<strong>in</strong>g therapeutic recommendations to doctors for optimisation of treatment outcomes. In addition, thepharmacists met with patients who started new cancer treatment and completed thorough medication reconciliation tocounsel patients on adm<strong>in</strong>istration and educate them on how to handle potential drug <strong>in</strong>teractions and toxicities.ObjectivesThe aim of this evaluation is to establish the role of cl<strong>in</strong>ical pharmacists <strong>in</strong> oncology wards and cl<strong>in</strong>ics by describ<strong>in</strong>g andquantify<strong>in</strong>g the risk level of different types of therapeutic <strong>in</strong>terventions and recommendations made by pharmacists.Wednesday, 15 MayMethodologyThe study was a retrospective descriptive analysis of therapeutic <strong>in</strong>terventions made by the oncology pharmacists fromSeptember 2010 to December 2012 <strong>in</strong>clusively. DRPs and their proposed therapeutic recommendations were documented,categorised and analysed <strong>in</strong> the electronic database designed by the Pharmacy Department. The proportion of each type of<strong>in</strong>terventions was calculated and analysed us<strong>in</strong>g a literature-based <strong>in</strong>strument accord<strong>in</strong>g to different severity levels.Results1,671 DRPs <strong>in</strong> total were identified dur<strong>in</strong>g the 28-month period. All these <strong>in</strong>terventions and recommendations weredocumented and evaluated by pharmacists. The severity and risk level of these <strong>in</strong>terventions were <strong>in</strong> the order from highto low risk, and ranged from “serious” (7.42%, n=124), “significant” (48.29%; n=807), “m<strong>in</strong>or” (22.02%; n=368) to “others”(22.26%; n=372). “Serious” level — drug could exacerbate patient’s condition (related to contra<strong>in</strong>dications); high dosageof drug with low therapeutic <strong>in</strong>dex. “Significant” level — drug dosage was too low for patient’s condition; errant dual-drugtherapy for s<strong>in</strong>gle condition; <strong>in</strong>appropriate dos<strong>in</strong>g <strong>in</strong>terval. “M<strong>in</strong>or” level — unavailable/<strong>in</strong>appropriate dosage form; noncompliancewith standard formulations and hospital policies. “Others” — clarifications made on the adm<strong>in</strong>istration date ofchemotherapy, proceed<strong>in</strong>g with chemotherapy for low blood counts. Given the importance of DRPs encountered, the valueof a ward and cl<strong>in</strong>ic based pharmacist is demonstrated by the pharmacists’ ability to identify and resolve DRPs. The resultsfrom this study proves the need of further development of the role of cl<strong>in</strong>ical pharmacists <strong>in</strong> enhanc<strong>in</strong>g medication safetyand as part of the multi-discipl<strong>in</strong>ary team <strong>in</strong> provid<strong>in</strong>g quality healthcare. Oncology cl<strong>in</strong>ical pharmacists br<strong>in</strong>g a thoroughunderstand<strong>in</strong>g of drug therapies, toxicities, monitor<strong>in</strong>g, and pharmacoeconomics to the multi-discipl<strong>in</strong>ary team.
Service Priorities and <strong>Programme</strong>s Free PapersSPP3.1 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221The Effectiveness of an Enhancement <strong>Programme</strong> on Management of Febrile Neutropenia <strong>in</strong> HaematologyAu KK 2 , Cheung MY 2 , Lee KKH 1,2 , Tang MKC 11Department of Medical and Geriatrics, 2 Haematology Unit, Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionNeutropenic sepsis is a potential fatal haematological emergency for patients with marrow failure either primary orsecondary to disease progression, immunosuppressant therapy, cytotoxic chemotherapy as well as haemtopoietic stem celltransplantation. Prompt management is life-sav<strong>in</strong>g and can prevent irreversible outcome through a structured and readilyaccessible service.ObjectivesThe objectives of this enhancement programme are: (1) to reduce unplanned hospital admissions through Accident andEmergency Department (AED); (2) to provide preventive measures through patient education and assessment; and (3) toprovide immediate <strong>in</strong>tervention and advise through help hotl<strong>in</strong>e at nurse-led cl<strong>in</strong>ic.97HOSPITAL AUTHORITY CONVENTION 2013MethodologyAfter 12 months service, there was 43% reduction (n=67 <strong>in</strong> 2011 vs n=38 <strong>in</strong> 2012) of neutropenic related sepsis admissionthrough AED <strong>in</strong>to general medical wards. There were 122 calls to the designated help hotl<strong>in</strong>e. 56% of these calls resulted<strong>in</strong> immediate day centre admission for septic work and management. 28% of them required phone advice and counsell<strong>in</strong>g.Only 16% of the calls f<strong>in</strong>ally attended the nearest AED. The fast track help hotl<strong>in</strong>e assessment triaged 69 cases to cl<strong>in</strong>icaladmission. The nurse-led cl<strong>in</strong>ic also provided early re-assessment with<strong>in</strong> one week. Given the cost of HK$2,659 for eachAED admission, there was a net sav<strong>in</strong>g of HK$183,471 and more importantly avoidance of delay <strong>in</strong> golden treatment timefor neutropenic fever dur<strong>in</strong>g AED triage, admission and consultation arrangement. Moreover, this review also demonstratedpatients satisfaction and competency <strong>in</strong> access<strong>in</strong>g the help hotl<strong>in</strong>e service.ResultsThis enhancement programme not only demonstrated the successfulness <strong>in</strong> provid<strong>in</strong>g prompt assessment to potentialfatal disease complication, but also promoted the important role of patients’ self-awareness as well as the <strong>in</strong>evitable role ofnurs<strong>in</strong>g profession <strong>in</strong> multi-discipl<strong>in</strong>ary approach and patient-centred care. Although some of the patients still required AEDattendance, this service model can be the cornerstone for future enhancement programme of high quality patient centredcare, as well as cost effectiveness <strong>in</strong> healthcare service utilisation.Wednesday, 15 May
98HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP3.2 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221The Impact of Teach<strong>in</strong>g Illness Management to Psychiatric Inpatients: A One Year Follow-upChao JYW 1 , Lee WK 2 , Huang TCF 3 , Yeung OSF 4 , Leung TKS 5 , Lee LCK 6 , U KFI 4 , Kan ELC 71Queen Mary Hospital, 2 Pamela Youde Nethersole Eastern Hospital, 3 Castle Peak Hospital, 4 Kwai Chung Hospital,5Kowloon Hospital, 6 Tai Po Hospital, 7 United Christian Hospital,Hong KongIntroductionLearn<strong>in</strong>g self-management for illness plays an important role <strong>in</strong> the recovery of people with severe mental illness. Majorityof mental patients admitted to psychiatric wards are diagnosed with schizophrenia and most of them have short stay <strong>in</strong> thehospital. The “Transform<strong>in</strong>g Relapse and Instill<strong>in</strong>g Prosperity (TRIP)” is a four-session, activity-based illness managementprogramme specially designed by occupational therapists for acute and sub-acute psychiatric <strong>in</strong>patient sett<strong>in</strong>g. It is basedon recovery oriented concept and empirical supported strategies of the Illness Management and Recovery <strong>Programme</strong>s.ObjectivesTo study the effectiveness and impact of the TRIP programme on patients with schizophrenia <strong>in</strong> <strong>in</strong>patient sett<strong>in</strong>gs.Wednesday, 15 MayMethodologyA one year follow-up study of a multi-centre, double-bl<strong>in</strong>ded, randomised controlled cl<strong>in</strong>ical trial of the TRIP programmecompared to traditional occupational therapy programme. The progress was compared to the basel<strong>in</strong>e results right after theprogramme, at three months and 12 months <strong>in</strong>tervals. Measurement <strong>in</strong>cludes patients’ <strong>in</strong>sight, treatment compliance, illnessself-management, self esteem and happ<strong>in</strong>ess.Results261 <strong>in</strong>patients diagnosed with schizophrenia were recruited from psychiatric wards from seven clusters <strong>in</strong> Hong Kong.243, 208 and 128 of them f<strong>in</strong>ished post, three-month and 12-month data collection respectively. Repeated measurementof Analysis of Variance (ANOVA) test found that the TRIP programme was significant <strong>in</strong> improv<strong>in</strong>g illness management andsuch knowledge was effectively ma<strong>in</strong>ta<strong>in</strong>ed for three months (F=3.923, p=.021), which specifically enhanced their knowledgeof mental illness (F=3.432, p=.033) and relapse prevention plann<strong>in</strong>g (F=6.720, p=.001). The impact of relapse preventionplann<strong>in</strong>g still rema<strong>in</strong>ed significant 12 months after the programme (F=4.263, p=.006). The TRIP appeared to be an effectiveprogramme <strong>in</strong> help<strong>in</strong>g patients to acquire knowledge <strong>in</strong> illness self-management <strong>in</strong> acute and sub-acute psychiatric <strong>in</strong>patientsett<strong>in</strong>g. This knowledge could be ma<strong>in</strong>ta<strong>in</strong>ed after their discharge and had significant impact on relapse prevention evenafter one year.
Service Priorities and <strong>Programme</strong>s Free PapersSPP3.3 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221Innovative Approach of Enhanc<strong>in</strong>g Patient Education Us<strong>in</strong>g “Diabetes Conversation Map” to Improve Outcomeand Insul<strong>in</strong> Commencement <strong>in</strong> General Outpatient Cl<strong>in</strong>ic (GOPC), Hong Kong East ClusterWong YF, Hung SY, Chu WSD, Law SFM, Leung YSD, Chan YLT, Poon KWL,Wong MYM, Leung TMV, S<strong>in</strong> MC, Kwan WYW,Wong KWJ, Chow WPAFamily Medic<strong>in</strong>e and Primary Healthcare, Hong Kong East ClusterIntroductionEducat<strong>in</strong>g and empower<strong>in</strong>g type 2 diabetes mellitus (T2DM) patients are cornerstones <strong>in</strong> disease management. GeneralOutpatient Cl<strong>in</strong>ic (GOPC) nurses of the Hong Kong East Cluster (HKEC) used to spend 15 to 20 m<strong>in</strong>utes provid<strong>in</strong>g <strong>in</strong>dividualeducation to each T2DM patients dur<strong>in</strong>g regular complication screen<strong>in</strong>g. However we observed that patients’ knowledgeretention was not good and some patients would cont<strong>in</strong>ue their usual lifestyle without any changes. We also encounteredproblems <strong>in</strong> engag<strong>in</strong>g patients with poor diabetes control to start <strong>in</strong>sul<strong>in</strong>. Studies showed that only 20% to 30% of patientsare will<strong>in</strong>g to start <strong>in</strong>sul<strong>in</strong>. The problem probably stemmed from <strong>in</strong>adequate <strong>in</strong>formation retention and patient empowerment.Studies found that people can reta<strong>in</strong> 50% more <strong>in</strong>formation through active learn<strong>in</strong>g (vs passive learn<strong>in</strong>g). In an attempt tosolve these problems, HKEC GOPCs adopt a new approach us<strong>in</strong>g Conversation Map Education tools s<strong>in</strong>ce August 2012.These tools are an <strong>in</strong>novative education method that empower diabetes patients to become actively <strong>in</strong>volved <strong>in</strong> manag<strong>in</strong>g thedisease through <strong>in</strong>teractive group participation.99HOSPITAL AUTHORITY CONVENTION 2013Objectives(1) To apply Conversation Map <strong>in</strong> T2DM education; and (2) to evaluate the effectiveness of education and its use <strong>in</strong> help<strong>in</strong>gpatients to start <strong>in</strong>sul<strong>in</strong> treatment.MethodologyThe HKEC Department of Family Medic<strong>in</strong>e and Primary Healthcare started send<strong>in</strong>g medical and nurs<strong>in</strong>g staff to the DMConversation Map tra<strong>in</strong><strong>in</strong>g workshops s<strong>in</strong>ce April 2012. S<strong>in</strong>ce August 2012, our nurs<strong>in</strong>g team has started regular conversationmap groups (each session with six to eight patients last<strong>in</strong>g 60 m<strong>in</strong>utes) us<strong>in</strong>g maps themed on “Walk with Insul<strong>in</strong>”, “Walk withDiabetes” and “Food and Exercise”. Patients were required to complete an evaluation form at the end of the sessions.ResultsFrom August 2012 to January 2013, 28 sessions were completed with a total attendance of 148 patients. Among allrespondents: 95% liked this “<strong>in</strong>teractive dialogue” format of learn<strong>in</strong>g; 88.9% learned a lot from other members <strong>in</strong> the group;92.7% could share their experience and participated <strong>in</strong> the group; 94.5% were very concentrated <strong>in</strong> the group; 87.7% rated>80 (out of 100) for the overall satisfaction rate; 73.0% of patients who had undergone “Walk with Insul<strong>in</strong>” map started <strong>in</strong>sul<strong>in</strong>treatment. More effective knowledge acquisition was achieved through active learn<strong>in</strong>g; and peer support was ga<strong>in</strong>ed tocreate strategies that turned <strong>in</strong>formation <strong>in</strong>to mean<strong>in</strong>gful, long last<strong>in</strong>g behavioural changes and positive habits. In the group,healthcare professionals also ga<strong>in</strong>ed a better understand<strong>in</strong>g of patients’ ideas and concerns <strong>in</strong> T2DM management. It is evenmore cost effective than the conventional approach <strong>in</strong> terms of time spent on each patient. It is an approach def<strong>in</strong>itely worthfurther exploration and application.Wednesday, 15 May
100HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP3.4 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221Effectiveness of the Trivalent Seasonal Influenza Vacc<strong>in</strong>e of Hong Kong Institutionalised Elderly: A 12-monthRetrospective Cohort StudyLaw TC 1 , Tse MY 2 , Chan TC 3 , Ng WC 1 , Chiu KC 31Community Geriatric Assessment Team, Hong Kong West Cluster, 2 Hong Kong Polytechnic University,3Department of Medic<strong>in</strong>e and Geriatrics, Fung Yiu K<strong>in</strong>g Hospital,Hong KongIntroductionElderly is one of the most at risk population for seasonal <strong>in</strong>fluenza <strong>in</strong>fection and <strong>in</strong>fluenza related mortality. The Departmentof Health of Hong Kong thus have an annual seasonal <strong>in</strong>fluenza vacc<strong>in</strong>ation programme for elderly liv<strong>in</strong>g <strong>in</strong> Residential CareHome for Elderly (RCHE), the group with the highest <strong>in</strong>fection rate and mortality. The vacc<strong>in</strong>ation rate of the annual <strong>in</strong>fluenzavacc<strong>in</strong>ation programme <strong>in</strong> general public <strong>in</strong> 2010 was very low.ObjectivesTo explore the efficacy of this trivalent <strong>in</strong>fluenza vacc<strong>in</strong>e <strong>in</strong> <strong>in</strong>stitutionalised elderly.Wednesday, 15 MayMethodologyIt was a 12-month retrospective cohort study performed <strong>in</strong> one Care and Attention Home (C&A Home) which was receiv<strong>in</strong>gthe Community Geriatric Assessment Service (CGAS) of Hong Kong West Cluster, and was will<strong>in</strong>g to participate <strong>in</strong> the studyfrom 19 December 2010 to 18 December 2011. Elderly aged 65 years or above <strong>in</strong> this C&A Home on or before 19 Decemberwere recruited to the programme and divided <strong>in</strong>to two groups accord<strong>in</strong>g to their choice of vacc<strong>in</strong>ation on the <strong>in</strong>fluenzavacc<strong>in</strong>e programme 2010 on 5 December 2010 (vacc<strong>in</strong>ated group vs unvacc<strong>in</strong>ated group). 12 months of laboratory confirmed<strong>in</strong>fluenza, <strong>in</strong>fluenza like illnesses (ILI), mortality and hospitalisation were collected.Results183 elderly aged 65 years or above were recruited to the programme: 119 (65%) of them received vacc<strong>in</strong>ation of the <strong>in</strong>fluenzavacc<strong>in</strong>e programme 2010 and 64 (35%) of them refused vacc<strong>in</strong>ation. The 12-month mortality rates of the vacc<strong>in</strong>ated groupand unvacc<strong>in</strong>ated group were 15.1% and 18.8% respectively (p=0.538). Multi-variate analysis demonstrated that thereduction of all causes of mortality through vacc<strong>in</strong>ation of RCHE elderly was <strong>in</strong>significant.ConclusionsThe study did not demonstrate that the <strong>in</strong>fluenza vacc<strong>in</strong>e programme 2010 was effective <strong>in</strong> reduc<strong>in</strong>g all causes of mortalityand hospitalisation of C&A Home elderly under study. It may be due to small sample size. Further research of large samplesize and on multiple homes should be performed.
Service Priorities and <strong>Programme</strong>s Free Papers101SPP3.5 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221New Paradigm <strong>in</strong> Manag<strong>in</strong>g Patients with Chronic Illness through Patient EngagementHo SS 1 , Lo KM 1 , Chan SY 2 , Chan KH 1 , Lau A 3 , Louie F 4 , Leung YH 5 , Ma HM 6 , Au LH 1 , Man YH 1 , Tam V 7 , Chan HS 1 , Cheng YL 11Department of Medic<strong>in</strong>e, Alice Ho Miu L<strong>in</strong>g Nethersole Hospital, 2 Community Outreach Service Team, Alice Ho Miu L<strong>in</strong>gNethersole Hospital, 3 Physiotherapy Department, Alice Ho Miu L<strong>in</strong>g Nethersole Hospital, 4 Occupational Therapy Department,Alice Ho Miu L<strong>in</strong>g Nethersole Hospital, 5 Department of Accident and Emergency, Alice Ho Miu L<strong>in</strong>g Nethersole Hospital,6Department of Medic<strong>in</strong>e, Tai Po Hospital, 7 Medical Social Work, Alice Ho Miu L<strong>in</strong>g Nethersole Hospital,Hong KongIntroductionThe shortfall of healthcare workforce requires a reth<strong>in</strong>k of prevail<strong>in</strong>g models for deliver<strong>in</strong>g care to patients with chronicdisease. A patient with chronic respiratory disease needs to be taken care by a multi-skilled team formed by healthcareprofessionals and with support from specialist. We need to explore new collaborations to deliver multi-discipl<strong>in</strong>ary healthcarefor handl<strong>in</strong>g patients with chronic respiratory disease and evaluate these for patient outcome and cost effectiveness.ObjectivesWe have set up a patient group called “The Better Breather Club” for patients with chronic obstructive pulmonary disease(COPD) <strong>in</strong> Tai Po <strong>in</strong> 2011. This support<strong>in</strong>g system provides an opportunity for chronic lung disease patients and their familiesto meet regularly and render mutual support among themselves. Through gather<strong>in</strong>gs, they could know more about theirhealth conditions from related healthcare professionals <strong>in</strong> a supportive environment. We identify all high risk chronic diseasepatients <strong>in</strong> the patient group and provide medical support especially dur<strong>in</strong>g w<strong>in</strong>ter surge or before long holidays so as toreduce avoidable hospitalisations.MethodologyHigh risk patients with >two emergency room attendances or hospital admissions for COPD exacerbations per year or GoldStage >two with co-morbidities or high symptom scores were recruited from the patient group. They were then assessed <strong>in</strong> aComb<strong>in</strong>ed Day Rehabilitation Centre. We provide <strong>in</strong>tegrated care to COPD patients <strong>in</strong>clud<strong>in</strong>g: (1) comprehensive <strong>in</strong>tervention;(2) <strong>in</strong>troduction of a self-management education programme; (3) <strong>in</strong>dividualised care plan; (4) enhanced accessibility tohealthcare professionals; and (5) regular phone contact by volunteers and clerical staff of the Club dur<strong>in</strong>g w<strong>in</strong>ter surge andbefore long holiday.ResultsWe have recruited 140 patients with chronic obstructive pulmonary disease to jo<strong>in</strong> “The Better Breather Club”. We haveidentified 76 high risk patients (11.8% female) with poor lung function (75% with stage three or four by GOLD guidel<strong>in</strong>e), comorbidities(93%), or poor social support as all of them are prone to repeated hospitalisations. Their mean age is 72 years old(49-89). 64.5% of the patients have completed pulmonary rehabilitation programme. 35.5% of them have received treatmentwith home O 2 and 20 patients have been referred for home non-<strong>in</strong>vasive ventilation. We have analysed 30 patients withquality of life questionnaires <strong>in</strong>clud<strong>in</strong>g St. George Respiratory Questionnaire and SF 12 after <strong>in</strong>tervention for 12 months us<strong>in</strong>g<strong>in</strong>tegrated care pathway. Significant improvement <strong>in</strong> the activity scores and symptom score were observed <strong>in</strong> the patientsof the <strong>in</strong>tervention group at 12 months follow-up. The <strong>in</strong>tegrated care approach is ideally suited to provide management ofchronic illness, such as COPD. We provide education and community support for respiratory patients as well as caregiversfor those cop<strong>in</strong>g with breath<strong>in</strong>g problems.HOSPITAL AUTHORITY CONVENTION 2013Wednesday, 15 May
102HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP3.6 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221Report of Pilot Empowerment <strong>Programme</strong> for Pakistani DiabeticsNg MP, Cheung YNE, Chan YTT, Mok PHM, Tsang MW, Lee PSPDiabetes Ambulatory Care Centre, United Christian Hospital, Hong KongIntroductionDiabetes self-management education is to empower patients through acquisition of diabetes knowledge, self-care practicesand cop<strong>in</strong>g skills to make better choices and have greater control of their life. Group-based approaches of diabetes selfmanagement<strong>in</strong>terventions have better self-care outcomes. In many studies, the ethnic m<strong>in</strong>ority has been identified as a riskfactor not only for hav<strong>in</strong>g type 2 diabetes mellitus (T2DM) but for <strong>in</strong>creased morbidity and mortality with the disease. In ourDiabetes Ambulatory Care Centre, we have been see<strong>in</strong>g T2DM patients from the ethnic m<strong>in</strong>ority who are passive <strong>in</strong> self-care.Cultural differences, belief and language have been the major barriers for the ethnic m<strong>in</strong>ority’s access to the DM services.With our Breakfast Club Model (multi-discipl<strong>in</strong>ary team approach) and an <strong>in</strong>terpreter’s help, a Pakistani Diabetic PatientGroup (PDPG) was formed <strong>in</strong> July 2011 to study how to improve passive participation.ObjectivesTo report the f<strong>in</strong>d<strong>in</strong>gs of the group-based diabetes self-management programme <strong>in</strong> PDPG <strong>in</strong> a local hospital <strong>in</strong> Hong Kong.Wednesday, 15 MayMethodologyPakistani diabetics were <strong>in</strong>vited to jo<strong>in</strong> the PDPG. They met every three months before formal consultation. Care providerswould expla<strong>in</strong> the concept of T2DM management <strong>in</strong> relation to diet, exercise and medication. In each meet<strong>in</strong>g, they wereencouraged to share their concerns, questions and problems. A total of six group meet<strong>in</strong>g at three-month <strong>in</strong>terval wereconducted. In last visit, we conducted a survey on their impression of this programme.ResultsEight patients (five male and three female) completed the survey with mean age of 47 years old and duration of DM of10.17 years. 60% of the Pakistani diabetics strongly agreed that the programme helped improve their diabetes knowledge,stimulate <strong>in</strong>teraction among peers with the help from healthcare professionals. 50% of the diabetics strongly agreed that theprogramme helped improve their self-management <strong>in</strong> daily life, <strong>in</strong>clud<strong>in</strong>g exercise, medication and self-monitor<strong>in</strong>g. Also theyenjoyed the group activity, especially the part of diabetes knowledge enhancement and shar<strong>in</strong>g of their experience <strong>in</strong> dailylife. 62.5% of the diabetics agreed that the programme could enhance their dietary management. All responses from thediabetics <strong>in</strong> survey was positive and they appreicated the service tailor-made for them accord<strong>in</strong>g to their culture. At the sametime, the care providers perceived greater job satisfaction from these responses.ConclusionsThe group-based programme does not only improve diabetes knowledge and motivate diabetes self-management of theethnic m<strong>in</strong>ority, but also enhance job satisfaction of the care providers. In future, it is suggested to <strong>in</strong>crease the variety of theprogramme, such as exercise for weight reduction.
Service Priorities and <strong>Programme</strong>s Free PapersSPP3.7 Consolidat<strong>in</strong>g Service Receivers 14:30 Room 221Multi-discipl<strong>in</strong>ary Supported Discharge <strong>Programme</strong> for Stroke Patients <strong>in</strong> Our Lady of Maryknoll Hospital (OLMH)Lau ST 1 , Yu YH 1 , Leung YF 1 , Tsang YF 1 , Wong KY 1 , Pang MH 1 , Poon MY 1 , Lam WY 1 , Poon TC 2 , Wong HY 21Department of Medic<strong>in</strong>e and Geriatrics, 2 Department of Occupational Therapy,Our Lady of Maryknoll Hospital, Hong KongIntroductionStroke patients and their caregivers often face many difficulties <strong>in</strong> daily activities <strong>in</strong> the early post discharge period. Theywould be overwhelmed with the unexpected demand <strong>in</strong> daily car<strong>in</strong>g issues with limited support. A multi-discipl<strong>in</strong>arysupport<strong>in</strong>g discharge programme was set up to facilitate stroke patients and their caregivers for better adaptation tocommunity dur<strong>in</strong>g this transition period. The multi-discipl<strong>in</strong>ary team consists of medical officers, nurses and occupationaltherapists.Objectives(1) To provide support to stroke patients and their caregivers dur<strong>in</strong>g the early post discharge period; (2) to identify thehealthcare needs and the sources of stress for stroke patients and their caregivers; and (3) to provide support and<strong>in</strong>tervention on healthcare needs <strong>in</strong> a timely manner.103HOSPITAL AUTHORITY CONVENTION 2013MethodologySubjects were recruited from stroke patients admitted to geriatric ward and planned to be discharged home between Januaryto October 2012. In this programme, pre-discharge plann<strong>in</strong>g with multi-discipl<strong>in</strong>ary approach was decided for <strong>in</strong>dividualpatient. Nurse performed post-discharge telephone follow-up on the first week, first month and third month. Occupationaltherapist performed home visit with<strong>in</strong> two days after the first telephone follow-up. Stroke round was carried out on weeklybasis for case review. Outcome measures <strong>in</strong>cluded: (1) Modified Barthel Index (MBI); (2) Modified Functional AmbulatoryCategories (MFAC); and (3) subjective stress level of patients and caregivers. Patient satisfaction survey was conducted forpatients and caregivers after the third month telephone follow-up.ResultsA total of 58 patients were recruited to this programme. More than half of the patients (57%) showed improvement <strong>in</strong> MBI andone-third of the patients (35%) showed improvement <strong>in</strong> MFAC on the third month telephone follow-up. One-third of patients(34%) and caregivers (33%) reported decrease <strong>in</strong> subjective stress level while 14% of patients and 12% of caregivers reported<strong>in</strong>crease <strong>in</strong> subjective stress level. The sources of stress were ma<strong>in</strong>ly limited progress <strong>in</strong> rehabilitation and exhaustion ofcaregivers. Most of the patients (about 70%) and caregivers (about 60%) found this programme helpful and were satisfiedwith the services received.Wednesday, 15 MayConclusionsThe multi-discipl<strong>in</strong>ary support<strong>in</strong>g discharge programme for stroke patients was well recognised by patients and caregivers.Cont<strong>in</strong>uity of care after discharge facilitates patients and caregivers to handle stress resulted from daily care at early postdischarge period. Future programme is encouraged to provide more support to facilitate stroke patients and caregivers toadapt to community liv<strong>in</strong>g smoothly.
104HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP4.1 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Wiser Project <strong>in</strong> Streaml<strong>in</strong><strong>in</strong>g Delivery Process of Three-Litre Normal Sal<strong>in</strong>e Irrigation FluidChan PT 1 , Ng YMW 1 ; Law KW 2 ; Ng YLE 31Department of Surgery, 2 Pharmacy Department, 3 Support<strong>in</strong>g Services Department,Queen Elizabeth Hospital, Hong KongIntroductionCont<strong>in</strong>uous bladder irrigation with normal sal<strong>in</strong>e is one of the treatment plans to prevent clot retention for management ofheamaturia. The three-litre normal sal<strong>in</strong>e irrigation fluid for daily consumption is about 70 bags <strong>in</strong> 30 cartons. The three-litrenormal sal<strong>in</strong>e irrigation fluid is delivered by pallet truck from Pharmacy to ward by four support<strong>in</strong>g staff, and after delivery,ward staff are required to unpack all the cartons <strong>in</strong> the treatment room before the irrigation fluid can be hanged up for patientuse. It does not only occupy the whole treatment room with bulk of garbages for disposal, but also cause high possibility ofstaff <strong>in</strong>jury, manpower and cost<strong>in</strong>g implications. Therefore a Wiser Project has been launched to streaml<strong>in</strong>e the delivery ofthe 70 bags of three-litre irrigation fluid daily.Objectives(1) To streaml<strong>in</strong>e the process of delivery of the three-litre fluid; (2) to reduce the potential risk of staff <strong>in</strong>jury due to manualhandl<strong>in</strong>g; (3) to improve spac<strong>in</strong>g of treatment room; (4) to improve <strong>in</strong>fection control with better environmental hygiene; and (5)to promote staff satisfaction.Wednesday, 15 MayMethodology(1) Re-design of delivery process — process of unpack<strong>in</strong>g of the three-litre normal sal<strong>in</strong>e would be done <strong>in</strong> Pharmacy <strong>in</strong>steadof treatment room. After unpack, the three-litre fluid would be placed <strong>in</strong>to a newly designed trolley for transport <strong>in</strong>steadof us<strong>in</strong>g pallet truck which <strong>in</strong>volved only one support<strong>in</strong>g staff. (2) Cross-departmental commitment — Pharmacy, CentralDelivery Team and Surgery Department were committed to the new delivery process. (3) F<strong>in</strong>ancial support — six tailor-madetrolleys were procured with budget support from Surgery Department to replace the pallet truck.Results(1) Manpower and man-hour was saved <strong>in</strong> delivery of the three-litre fluid from Pharmacy to ward with one support<strong>in</strong>g staff<strong>in</strong>stead of four. (2) The tailor-made trolley held 24 bags of three-litre fluid which was only 26% of the previous weight held bypallet truck, and could be managed by one support<strong>in</strong>g staff. (3) Reduce garbage storage and <strong>in</strong>crease spac<strong>in</strong>g of treatmentroom. (4) Lean management was applied <strong>in</strong> dispos<strong>in</strong>g cartons directly from Pharmacy for re-cycl<strong>in</strong>g <strong>in</strong>stead of transport<strong>in</strong>gfrom ward. (5) Spared more support<strong>in</strong>g staff <strong>in</strong> provid<strong>in</strong>g patient care. (6) M<strong>in</strong>imise chances of staff <strong>in</strong>jury. (7) Staffs weresatisfied with the project.ConclusionIt is a successful cross-departmental Wiser Project with little resources <strong>in</strong>put but good returns. All parties <strong>in</strong>volved aresatisfied with the w<strong>in</strong>-w<strong>in</strong> outcomes.
Service Priorities and <strong>Programme</strong>s Free PapersSPP4.2 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Domiciliary Non-<strong>in</strong>vasive Ventilation Service for Patients with Chronic Respiratory FailureChan YY, Ng SW, Poon CL, Choi MW, Tse KC, Chan LV, Leung WS, Chu CMRespiratory Division, United Christian Hospital, Hong KongIntroductionChronic obstructive pulmonary disease (COPD) is one of the lead<strong>in</strong>g causes of mortality worldwide and the prevalence isexpected to be more than double by 2030. Patients with COPD or other chronic lung diseases <strong>in</strong> the advanced stage oftensuffered from severe breathlessness and recurrent respiratory decompensation which require frequent hospitalisationsto manage their disease. In order to manage the grow<strong>in</strong>g demand of healthcare utilisation of these patients, a domiciliarynon-<strong>in</strong>vasive ventilation (NIV) programme has been established <strong>in</strong> a local acute hospital to provide comprehensive care forpatients with chronic respiratory failure s<strong>in</strong>ce 2004.ObjectivesTo evaluate the effectiveness of the domiciliary NIV service related to healthcare utilisation of patients before and after<strong>in</strong>itiation of domiciliary NIV.105HOSPITAL AUTHORITY CONVENTION 2013MethodologyThe domiciliary NIV programme was run by qualified respiratory nurses and physicians. The programme provides structured,proactive and specialised service to patients who required long-term use of NIV. Healthcare utilisation <strong>in</strong>clud<strong>in</strong>g emergencydepartment attendance, unplanned admission and average length of stay were evaluated after patients discharged with<strong>in</strong>itiation of domiciliary NIV. One-year healthcare utilisation of patients receiv<strong>in</strong>g domiciliary NIV before and after wasreviewed.ResultsThere were 155 patients with 132 male and 23 female recruited dur<strong>in</strong>g January 2005 to December 2011 <strong>in</strong>clusively. The meanage was 71.37 (range 30 to 95). Majority of them were COPD patients (70.97%); the rema<strong>in</strong><strong>in</strong>g were patients with obstructivesleep apnea (5.81%), restrictive lung disease (7.1%), motor-neurone disease (3.22%), overlapped syndrome (5.8%) andother chronic disease (7.1%). 39 patients (25.16%) died with<strong>in</strong> one year after discharged with domiciliary NIV. After receiv<strong>in</strong>gdomiciliary NIV service, there were significant reduction <strong>in</strong> healthcare utilisation <strong>in</strong>clud<strong>in</strong>g pre- (3.68) and post- (2.5) averageemergency attendance (p=0.001), pre- (3.25) and post- (2.1) average unplanned admission (p
106HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP4.3 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Cardiopulmonary Bypass — an Evidence-based Change of PracticeFung SH 1 , Das S 21F5 Operat<strong>in</strong>g Theatre, Cardiothoracic Surgical Department, 2 Department of Cardiothoracic Anaesthesia,Queen Mary Hospital, Hong KongIntroductionOf the nearly 1,000 cardiac surgical procedures perform annually at Queen Mary Hospital, Hong Kong’s premier cardiacsurgical centre, many of them belong to very high risk category, with some of the patients present<strong>in</strong>g as extreme lifethreaten<strong>in</strong>gconditions that require immediate surgery. Extracorporeal circulation or cardiopulmonary bypass (CPB) is an<strong>in</strong>dispensable component of “open-heart” surgery. Management of CPB is the key responsibility of the perfusionist, a highlytra<strong>in</strong>ed professional who not only operates the CPB mach<strong>in</strong>e, but also helps ma<strong>in</strong>ta<strong>in</strong> and preserve the normal physiologicalstatus of the patient dur<strong>in</strong>g the period of CPB, thus vitally <strong>in</strong>fluenc<strong>in</strong>g the eventual outcome of the patient. Sett<strong>in</strong>g up theCPB mach<strong>in</strong>e and circuitry is an arduous responsibility that requires great attention to precision and safety. Under normalcircumstances, it takes about 25 to 30 m<strong>in</strong>utes to set up the CPB circuit, prime it with appropriate fluid, and get it readyfor an open heart surgery. However, certa<strong>in</strong> cardiac surgical emergencies may not allow the luxury of so much preparationtime. Rapid <strong>in</strong>stitution of CPB may offer the only hope for survival. Such emergencies often happen outside normal work<strong>in</strong>ghours. The urgency and nature of emergency put enormous stress on the entire team, especially the perfusionist who may bework<strong>in</strong>g s<strong>in</strong>gle-handedly <strong>in</strong> a frantic race aga<strong>in</strong>st time.Wednesday, 15 MayObjectivesTo <strong>in</strong>itiate evidence-based change <strong>in</strong> practice to better address such dire emergencies: (1) to evaluate safety and efficacyof a “preassembled dry, ready to use, CPB circuit” prepared up to 48 hours <strong>in</strong> advance of a surgical procedure; and (2) toenhance patient safety by enabl<strong>in</strong>g very rapid establishment of CPB.MethodologyThe <strong>in</strong>tended change <strong>in</strong> practice was <strong>in</strong>itiated after reach<strong>in</strong>g consensus among perfusionists, cardiac anaesthetists,surgeons and the Infection Control Team <strong>in</strong> our hospital. A protocol was set up for the perfusion team to follow. Accord<strong>in</strong>gly,the “preassembled dry CPB circuit” was prepared <strong>in</strong> the Cardiac Operat<strong>in</strong>g Theatres under aseptic conditions as usual, thenwrapped <strong>in</strong> sterile towels and kept on a sterile trolley for up to a maximum of 48 hours, the duration for which the circuitrywas hypothesised to be sterile. This hypothesis was tested <strong>in</strong> a pilot trial which carried out between 1 January 2011 to 27June 2011, dur<strong>in</strong>g which period samples of prim<strong>in</strong>g fluid were obta<strong>in</strong>ed from 30 consecutive “preassembled circuits” formicrobiological exam<strong>in</strong>ation. All culture results demonstrated sterility even after five days of <strong>in</strong>cubation. The first five circuitswere discarded. After the first five sterile samples, subsequent preassembled circuits were used. Thus dur<strong>in</strong>g the 48-hourshelf life of the “preassembled dry circuit” was either used for an emergency open heart operation, or if no such emergencypresented dur<strong>in</strong>g the time, it was used up for an elective operation. Thus there was no wastage.ResultsThe time required to prime a “preassembled dry circuit” was 10 m<strong>in</strong>utes, significantly shorter than 25 m<strong>in</strong>utes.Microbiological surveillance proved the new practice to be entirely safe from the po<strong>in</strong>t of view of <strong>in</strong>fection. Indeed there wasno <strong>in</strong>crease <strong>in</strong> the <strong>in</strong>cidence of <strong>in</strong>fections <strong>in</strong> our patients. After the pilot trial of 30 circuits, the practice of a “preassembleddry CPB circuit” was <strong>in</strong>corporated <strong>in</strong>to our rout<strong>in</strong>e practice. This change has significantly enhanced the safety marg<strong>in</strong> forcritical emergencies, <strong>in</strong>creased the team’s confidence, and above all helped reduce the stress levels of personnel <strong>in</strong> suchcrises. Overall there has been a very positive impact. In future, we shall endeavour to extend the safe shelf-life to 72 hours.
Service Priorities and <strong>Programme</strong>s Free PapersSPP4.4 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Enhancement <strong>in</strong> Radiotherapy Treatment for Breast Cancer Patients: From One-by-one to Cont<strong>in</strong>uousWong KLA, Lam R, Tsang WW, Tai KKT, Wong SMT, Cheng TSM, Lui MMC, Wong CSFDepartment of Cl<strong>in</strong>ical Oncology, Tuen Mun Hospital, Hong KongIntroductionBreast cancer is a common female cancer <strong>in</strong> Hong Kong. Radiotherapy treatment will be given to patient after breast surgeryand chemotherapy. Breast cancer patients will receive external beam radiotherapy treatment conta<strong>in</strong><strong>in</strong>g eight “load andtreat” cycles, which will be treated one-by-one, lead<strong>in</strong>g to a long treatment time and pre-treatment wait<strong>in</strong>g time.Objectives(1) To reduce treatment time, shorten pre-treatment wait<strong>in</strong>g time; (2) to <strong>in</strong>crease radiotherapy mach<strong>in</strong>e throughput andtreatment efficiency; and (3) to enhance patient’s satisfaction <strong>in</strong> healthcare service.MethodologyConvert treatment plan from “one-by-one” mode to “cont<strong>in</strong>uous” mode by comb<strong>in</strong><strong>in</strong>g fields <strong>in</strong>to packages and treatcont<strong>in</strong>uously. The “load and treat” cycle can be reduced from eight to two. The treatment time was measured and collected,then the shorten<strong>in</strong>g of pre-treatment wait<strong>in</strong>g time and the <strong>in</strong>crease <strong>in</strong> number of treated cases can be calculated.107HOSPITAL AUTHORITY CONVENTION 2013ResultsThe new technique started on August 2012. The treatment time was reduced by 46% (from 240 seconds to 130 seconds). Thetotal number of daily treated breast cases were <strong>in</strong>creased by 19% (from 16 cases/day to 19 cases/day). The pre-treatmentwait<strong>in</strong>g time was shortened from two-to-four weeks to one-to-three weeks. The new treatment plan was effective <strong>in</strong> reduc<strong>in</strong>gtreatment time, shorten<strong>in</strong>g pre-treatment wait<strong>in</strong>g time and <strong>in</strong>creas<strong>in</strong>g the number of cases treated <strong>in</strong> daily cl<strong>in</strong>ical service. Allbreast cancer cases receiv<strong>in</strong>g radiotherapy <strong>in</strong> Tuen Mun Hospital are now switched to use the new technique.Wednesday, 15 May
108HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP4.5 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Innovative Lymphedema Management <strong>Programme</strong> (LMP) <strong>in</strong> Tung Wah Hospital (TWH) for Breast Cancer Patientsto Improve Service Efficiency and EffectivenessLeung SY 1 , So E 1 , Wong S 1 , Kwong A 2 , Suen D 21Physiotherapy Department, Tung Wah Hospital, 2 Department of Surgery, Queen Mary Hospital/Tung Wah Hospital,Hong KongIntroductionLymphedema is one of the most significant complications after breast cancer surgery. The physiotherapist and certifiedlymphedema therapist have <strong>in</strong>troduced the Complete Decongestive Therapy (CDT) <strong>in</strong> Tung Wah Hospital (TWH) s<strong>in</strong>ce 2011.CDT is an evidence-based <strong>in</strong>ternational gold standard for treat<strong>in</strong>g lymphedema. The components <strong>in</strong>clude manual lymphdra<strong>in</strong>age, compression bandag<strong>in</strong>g, remedial exercise, meticulous sk<strong>in</strong> and nail care, and <strong>in</strong>structions on self-care. An<strong>in</strong>novative structural Lymphedema Management <strong>Programme</strong> (LMP) was established <strong>in</strong> July 2012 that patient empowermentwas highly emphasised with specific goal <strong>in</strong> each session.Objectives(1) To m<strong>in</strong>imise patients’ suffer<strong>in</strong>g; (2) to better the use of resource; and (3) to improve the effective use of treatment sessions.Wednesday, 15 MayMethodologySubjects with lymphedema were recruited <strong>in</strong> non-structural prior programme (PP) (January 2011 to June 2012, 18 months<strong>in</strong> total) and structural LMP (July to December 2012, six months <strong>in</strong> total). The additional <strong>in</strong>clusion criteria of LMP were: (1)required treatments on all five CDT components; and (2) agreed to perform self-management. Outcome measures of LMPwere compared to the PP <strong>in</strong>: (1) wait<strong>in</strong>g time (from <strong>in</strong>itial assessment to the first session of treatment); (2) total follow-upperiod required (from <strong>in</strong>itial assessment to discharge date); (3) arm circumference; and (4) satisfaction survey <strong>in</strong> LMP.Results27 and five patients were recruited to the PP and LMP respectively. The results of PP were compared aga<strong>in</strong>st LMP. The meanwait<strong>in</strong>g time reduced from 105.4 days to 30.8 days and the mean total follow-up period required decreased from 141.7 daysto 69 days. Through LMP, patients could be discharged with<strong>in</strong> approximately six sessions of treatment whereas the meanarm circumference reduction was 21.5% and the mean subjective overall improvement was 48.8%. Besides, 80% patientsunderstood the needs and advantages of self-management, agreed that self-management could improve lymphedema andLMP could help them.ConclusionsS<strong>in</strong>ce the wait<strong>in</strong>g time <strong>in</strong> LMP was shortened, patients’ suffer<strong>in</strong>g could be m<strong>in</strong>imised. As the total follow-up period requiredwas shorter, more new patients could be treated and hence better the use of resource. Furthermore, lymphedema couldbe improved after approximately six sessions of follow-up, effective use of treatment session was achieved. However, thesubject number <strong>in</strong> LMP was small, further study on effectiveness is needed.
Service Priorities and <strong>Programme</strong>s Free PapersSPP4.6 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Protocol Driven Assessment <strong>Programme</strong> Effectively Shortens New Case Wait<strong>in</strong>g TimeLeung SK 1 , Woo YC 1 , Lau TWT 1 , Lam JKY 1 , Hui EYL 1, 2 , Tan KCB 1, 2 , Chow WS 1 , Yeung CY 1 , Yuen MYA 1 , Lee PCH 1 , Lee ACH 1 ,Wong KKC 1 , Leung ELY 1 and Lam KSL 1, 21Department of Medic<strong>in</strong>e, Queen Mary Hospital, 2 Department of Medic<strong>in</strong>e, The University of Hong Kong,Hong KongIntroductionThe wait<strong>in</strong>g time for new cases <strong>in</strong> endocr<strong>in</strong>e cl<strong>in</strong>ic has been ris<strong>in</strong>g due to <strong>in</strong>creas<strong>in</strong>g demand. The average wait<strong>in</strong>g time has<strong>in</strong>creased to 26.3 ± 5.5 weeks <strong>in</strong> February 2012. To improve the situation, a protocol driven assessment (PDA) programmehas been established and <strong>in</strong>corporated <strong>in</strong>to the triage pathway start<strong>in</strong>g from April 2012.Objectives(1) To shorten the wait<strong>in</strong>g time of new case at the Endocr<strong>in</strong>e Cl<strong>in</strong>ic; and (2) to enhance efficient work flow of triage system andimprove patient care.109HOSPITAL AUTHORITY CONVENTION 2013MethodologyProtocols for endocr<strong>in</strong>e diseases <strong>in</strong>clud<strong>in</strong>g obesity, hyperprolact<strong>in</strong>aemia, hypercalcaemia, hypopituitarism andhypogonadism were developed. Patients referred for such conditions were triaged to the PDA programme <strong>in</strong> which historytak<strong>in</strong>g, assessments, <strong>in</strong>vestigations and early <strong>in</strong>terventions were carried out accord<strong>in</strong>g to the protocols set by an endocr<strong>in</strong>enurse and subsequently followed by endocr<strong>in</strong>ologists.Results225 referrals were screened from May 2012 to December 2012. 64 patients were triaged to the programme. The referralto-nurseand referral-to-endocr<strong>in</strong>ologist times for the programme were 5.9 ± 4.9 and 9.8 ± 5.3 weeks respectively. Thisshowed a significant improvement when compared with their orig<strong>in</strong>al referral-to-endocr<strong>in</strong>ologist time (26.6 ± 5.7 weeks,p
110HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP4.7 Quality and Safety <strong>in</strong> Healthcare I 16:15 Room 221Ten-po<strong>in</strong>t System of Pr<strong>in</strong>cess Margaret Hospital Cardiac Intervention CentreTsui PT, Au YF, Cheung WYGDepartment of Medic<strong>in</strong>e and Geriatrics, Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionThere are <strong>in</strong>creas<strong>in</strong>g varieties and complexities of percutaneous cardiac <strong>in</strong>terventional procedures. Patients, their relativesand cardiologists have high expectations of hav<strong>in</strong>g <strong>in</strong>tervention performed as early as possible. Unrealistic over<strong>book</strong><strong>in</strong>g,cases overrun, staff overtime and frequent postponement of appo<strong>in</strong>tment were putt<strong>in</strong>g up tension <strong>in</strong> cardiac <strong>in</strong>terventioncentre (CIC) and entic<strong>in</strong>g patient dissatisfaction or even compla<strong>in</strong>ts. First come first served may not be the best rule forpatients with very different cl<strong>in</strong>ical needs.ObjectivesA structured and mutually agreed <strong>book</strong><strong>in</strong>g and schedul<strong>in</strong>g system was established to bridge this service gap. We <strong>in</strong>novate sothat our services excel regularly.Wednesday, 15 MayMethodologyEvery CIC procedure was assigned to a work unit <strong>in</strong> terms of po<strong>in</strong>ts based on complexity and past record of averageoperation time. More time slots were allocated to urgent than elective cases. The elective plus urgent case load should notexceed six po<strong>in</strong>ts <strong>in</strong> am and four po<strong>in</strong>ts <strong>in</strong> pm session. Only emergency case was allowed to break the ten-po<strong>in</strong>t rule. One ormore cases had to be cancelled immediately if an emergency case broke the ten-po<strong>in</strong>t rule to allow early release of patientsfrom pre-procedural rout<strong>in</strong>es. Stand-by urgent case <strong>book</strong><strong>in</strong>g would not be allowed if it caused the case load to exceedsix po<strong>in</strong>ts <strong>in</strong> am or four po<strong>in</strong>ts <strong>in</strong> pm session. Cancelled scheduled or legitimate stand-by cases would be given priority<strong>in</strong> re-schedul<strong>in</strong>g. Dur<strong>in</strong>g the pre-procedure assessment, patients and their relatives were <strong>in</strong>formed of the possibility ofpostponement or advancement should there be emergency or cancelled cases respectively. Session-<strong>in</strong>-charge doctor shouldreschedule the appo<strong>in</strong>tment as soon as possible for all cancelled cases. Doctor <strong>in</strong>-charge of pre-procedure assessmentshould <strong>in</strong>terview patient and/or relatives <strong>in</strong> person or by phone to expla<strong>in</strong> the situation before patient was discharged home.Operators do<strong>in</strong>g the last case of each day and anticipat<strong>in</strong>g capacity for add<strong>in</strong>g cases should <strong>in</strong>form nurs<strong>in</strong>g staff to callstand-by cases. Operators should not deviate too much from the expected procedural time and should consider stagedprocedure for complex <strong>in</strong>tervention.ResultsCIC throughput, number of cases postponed and nurs<strong>in</strong>g staff overtime hours were compared before (4 April to 7 October2011) and after (8 October to 9 March 2012) implementation of the ten-po<strong>in</strong>t system. Significant improvement <strong>in</strong> allparameters was noted. The CIC throughput <strong>in</strong>creased from 4.5 to 6.9 units per work<strong>in</strong>g day. Number of cases postponeddue to overrun was reduced from 0.34 to 0.19 case per work<strong>in</strong>g day. Nurs<strong>in</strong>g staff overtime decreased from 53 m<strong>in</strong>utes to 43m<strong>in</strong>utes per work<strong>in</strong>g day. An open, transparent and structured <strong>book</strong><strong>in</strong>g and schedul<strong>in</strong>g system allows most efficient use ofCIC resources and m<strong>in</strong>imises dissatisfaction of both patients and healthcare workers.
111AbstractsThursday, 16 May 2013112 SymposiumsS1 to S12129 MasterclassesMC1 to MC4HOSPITAL AUTHORITY CONVENTION 2013137139Special TopicsST3 to ST4Corporate ScholarshipPresentationsCS1 to CS2Thursday, 16 May145Service Priorities and<strong>Programme</strong>s Free PapersSPP5 to SPP8
112HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS1.1 Patient Safety 09:00 Convention Hall AQuality Healthcare: Cultural Change for Quality, Patient Safety and ValueEaston JCare UK, UKThe speaker led the largest <strong>in</strong>ternational programme of healthcare improvement <strong>in</strong> the capacity of National Director forTransformation for the National Health Service <strong>in</strong> England.It is widely acknowledged that achiev<strong>in</strong>g transformations <strong>in</strong> healthcare system performance for improved quality, safety andvalue requires more than technical improvements. Underp<strong>in</strong>n<strong>in</strong>g those developments is a requirement to change the cultureof systems, organisations, teams and <strong>in</strong>dividuals.In this symposium, why achiev<strong>in</strong>g such cultural change is a particular challenge <strong>in</strong> healthcare, given the nature of work, itsprofessional <strong>in</strong>heritance and challeng<strong>in</strong>g environment will be outl<strong>in</strong>ed.Then, how the co-ord<strong>in</strong>ated application of a number of levers for change will be outl<strong>in</strong>ed, <strong>in</strong>clud<strong>in</strong>g leadership development,engagement, <strong>in</strong>centive structures, performance management, quality improvement methods and strategies for spread ofeffective practice to develop and achieve the cultural change required.The speaker will reflect from the English National Health Service on the extent to which these approaches can achievepositive change when applied well, or, if misdirected, create negative cultures which have a bad impact on patient care.Thursday, 16 MayS1.2 Patient Safety 09:00 Convention Hall ACl<strong>in</strong>ical Risk ManagementHaxby EQuality and Safety Department, Royal Brompton and Harefield NHS Foundation Trust, UKTraditionally cl<strong>in</strong>ical risk management has focused on patients; health status, age, type of <strong>in</strong>tervention and urgency. Cl<strong>in</strong>iciansspend a lot of time and effort assess<strong>in</strong>g the risks of particular procedures to patients and attempt<strong>in</strong>g to manage that riskby optimis<strong>in</strong>g the patient’s condition prior to <strong>in</strong>tervention. However it is clear that much of the risk that exists sits with<strong>in</strong> thehealthcare environment; systems of care, knowledge, skills and competence of healthcare professionals and <strong>in</strong>teractionsbetween people, technology and organisations. In order to manage these risks, healthcare organisations must articulatestrategies and frameworks which are then implemented to ensure that patients received the right care by an appropriatelytra<strong>in</strong>ed <strong>in</strong>dividual with the right equipment <strong>in</strong> the right place at the right time. Standardisation and reliability <strong>in</strong> healthcarepractice are associated with better outcomes and reductions <strong>in</strong> adverse events. This approach requires commitmentfrom leaders with<strong>in</strong> the organisation to provide resources to support healthcare teams as well as to monitor the impact ofthese strategies through patient outcomes and other measurable quality <strong>in</strong>dicators <strong>in</strong>clud<strong>in</strong>g feedback on patient and staffexperience.
SymposiumsS1.3 Patient Safety 09:00 Convention Hall AProcedural Sedation: Challenges and OpportunitiesChow YFDepartment of Anaesthesiology and Operat<strong>in</strong>g Theatre Services, Queen Elizabeth Hospital, Hong KongSedation is frequently adm<strong>in</strong>istered to facilitate pa<strong>in</strong>ful and/or uncomfortable procedures. Successful cl<strong>in</strong>ical outcomedepends on safe sedation practice. Normally, sedation is claimed to be safe but case reports of unexpected mortalitykeeps com<strong>in</strong>g up while morbidity occurrences vary greatly. This has resulted <strong>in</strong> a number of controversies and differentstakeholders are engaged for debate.If we believe that “one is too many” for mortality related to sedation, there are numerous challenges and opportunities towork on <strong>in</strong> this area. This lecture will cover safety issues, exist<strong>in</strong>g guidel<strong>in</strong>es and system perspectives related to the practiceof procedural sedation <strong>in</strong> Hong Kong, <strong>in</strong>clud<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g, workforce, equipment and facilities.113HOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 May
114HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS2 Partner<strong>in</strong>g with Patients 10:45 Convention Hall AHospital Authority City Forum — Partner<strong>in</strong>g with Patients醫 管 局 城 市 論 壇 — 醫 患 同 行Discussion Panel Members:Tsang KP, Alliance for Patients’ Mutual Help Organisation, Hong KongLeung KP, Executive Committee, Alliance for Patients’ Mutual Help Organisation, Hong KongYip SWL, Public Compla<strong>in</strong>ts Committee, Hospital Authority, Hong KongDai D, Primary and Community Services, Hospital Authority, Hong KongSiu KLS, Doctors’ Union, Pr<strong>in</strong>cess Margaret Hospital, Hong KongWong YL, Department of Medic<strong>in</strong>e and Therapeutics, Pr<strong>in</strong>ce of Wales Hospital, Hong KongPatient engagement is the key driver <strong>in</strong> transformation of healthcare delivery system. Evidences show that when patientsbecome active participants <strong>in</strong> their care, they are more motivated to assume responsibility for manag<strong>in</strong>g their own health.When that happens, the results are better outcomes for the patient, and lower costs and better performance for the hospital.Patient engagement is also the cornerstone of quality and safety <strong>in</strong> patient care. Community and patient feedback isimportant for sett<strong>in</strong>g hospitals’ service directions and identify<strong>in</strong>g systemic deficiencies while re<strong>in</strong>forc<strong>in</strong>g public confidence<strong>in</strong> healthcare system. Besides, <strong>in</strong>dividuals can also be benefited through participation <strong>in</strong> their care process, such as bettermanagement of the disease, <strong>in</strong>creased satisfaction towards the service received, and greater trust towards their healthcareproviders. Patients’ knowledgeable and active <strong>in</strong>volvement can also foster a close patient-professional cooperation,partnership and relationship.Thursday, 16 MayIn this forum, guests from different perspectives, patient advocates to healthcare providers, management to front-l<strong>in</strong>eworkers, will be <strong>in</strong>vited to share their experience and the challenges they met <strong>in</strong> patient engagement.We believe that <strong>in</strong> order to realise the benefit of patient engagement, we will have to change the way we deliver care. We mustmove from a model where care is delivered to the patient to one that care is delivered with the patient. Healthcare services,despite all the scientific and technological advances are still human services. While there will always be patients to care for,the more their voice is heard, the more our healthcare system can move forward.S3 Maximis<strong>in</strong>g Efficiency 13:15 Convention Hall AHospital Authority City Forum — Next Step <strong>in</strong> Community Care醫 管 局 城 市 論 壇 — 社 區 照 顧 的 下 一 步Discussion Panel Members:Choo KL, Medic<strong>in</strong>e Department, North District Hospital, Hong KongHui E, Medical and Geriatrics Department, Shat<strong>in</strong> Hospital, Hong KongChan KS, Medic<strong>in</strong>e Department, Haven of Hope Hospital, Hong KongWong CP, Department of Geriatrics, Ruttonjee Hospital, Hong KongChan M, Community Nurs<strong>in</strong>g Service, Pr<strong>in</strong>cess Margaret Hospital, Hong KongThe Hospital Authority (HA) <strong>in</strong>itiated many community care programmes <strong>in</strong> the past years. Most of these programmeshave demonstrated success <strong>in</strong> car<strong>in</strong>g patients <strong>in</strong> the community and reduc<strong>in</strong>g the need for hospitalisation. However, manyprogrammes rema<strong>in</strong>ed local practices and could not be scaled up to a corporate level and be adopted <strong>in</strong> all clusters.Individual programmes also tended to run on their own and could not <strong>in</strong>tegrate well with other programmes. In this HA CityForum, advocates for various community care models will be <strong>in</strong>vited to share their success and obstacles. The discussionwill focus on what next and how to achieve greater system effectiveness <strong>in</strong> provision of community care under HA.
SymposiumsS4.1 Change: How? 14:30 Convention Hall AIntroduc<strong>in</strong>g High Volume Cataract Surgery <strong>in</strong> Hong Kong: Improv<strong>in</strong>g Surgeon Efficiency Without Sacrific<strong>in</strong>gPatient SafetyWong DS 1, 2 , Shih KC 1, 2 , Chan SK 21Department of Ophthalmology, The University of Hong Kong, 2 Hong Kong West Cluster Ophthalmic Service, Hospital Authority,Hong KongThere is an <strong>in</strong>creas<strong>in</strong>g demand for cataract surgery <strong>in</strong> the Hospital Authority due to the ag<strong>in</strong>g population <strong>in</strong> Hong Kong. The<strong>in</strong>troduction of high volume cataract surgery is aimed at <strong>in</strong>creas<strong>in</strong>g efficiency of service by reduc<strong>in</strong>g turnover time <strong>in</strong> betweenoperations. This allows for more operations to be performed per allocated time slot. Furthermore, regular participation <strong>in</strong> highvolume surgery, as evidenced by results <strong>in</strong> other specialties, may improve <strong>in</strong>dividual surgeon competency and efficiency.A prospective audit was performed on patients who underwent cataract surgery at Grantham Cataract Centre between 1 stJanuary 2010 to 31 st December 2011. Operative records of the patients were reviewed for the study and separated accord<strong>in</strong>gto surgeon. Analysis was restricted to surgeons, who were registered specialists <strong>in</strong> ophthalmology, and performed at least600 cataract surgeries dur<strong>in</strong>g the study period. Exclusion criteria <strong>in</strong>cluded surgeries performed on resident tra<strong>in</strong><strong>in</strong>g lists, orby more than one surgeon; and either extracapsular or <strong>in</strong>tracapsular cataract extraction was the primary procedure. Fourmonthly average operat<strong>in</strong>g times were calculated for each surgeon and compared over time.115HOSPITAL AUTHORITY CONVENTION 2013A total of six surgeons met the <strong>in</strong>clusion criteria for the study. Average operative time dur<strong>in</strong>g the first quadrimester was 21:21.There was a stepwise reduction on subsequent quadrimesters: 19:43, 18:22, 18:13, 16:40 and 16:03. Controlled for <strong>in</strong>dividualsurgeons, the step-wise reduction <strong>in</strong> operative time rema<strong>in</strong>ed. A similar relationship with phacoemulsification time wasobserved dur<strong>in</strong>g the study period. The <strong>in</strong>traoperative posterior capsular rupture and/or vitreous loss rate was also shown todecl<strong>in</strong>e with duration of <strong>in</strong>volvement <strong>in</strong> high volume surgery.Surgeon participation <strong>in</strong> high volume cataract surgery is associated with reduction <strong>in</strong> <strong>in</strong>dividual operat<strong>in</strong>g time and<strong>in</strong>traoperative complication rate. There was no evidence of a learn<strong>in</strong>g curve <strong>in</strong> the <strong>in</strong>itial study period.S4.2 Change: How? 14:30 Convention Hall AThursday, 16 MayPrerequisite for Ambulatory Day TonsillectomyAbdullah VDepartment of Ear, Nose and Throat, United Christian Hospital, Hong KongAdequacy of a day surgical case becomes relevant only if patient’s satisfaction could be achieved all round. In the West, daycase tonsillectomy, mostly performed <strong>in</strong> children is an ancient subject from the 1980s and is well established and expand<strong>in</strong>g<strong>in</strong> places like Denmark, Netherlands, North America though not so much <strong>in</strong> United K<strong>in</strong>gdom. In Asia Pacific region, surgeonsare still, wisely, reserved on the procedure. The bottom l<strong>in</strong>e is that evidently, the majority of parents, usually without a choice,do not enjoy or like it.We report our experiences <strong>in</strong> 89 cases of adult tonsillectomy performed over four years <strong>in</strong> a customised ear, nose andthroat (ENT) day surgical unit at Tseung Kwan O Hospital, Hong Kong. The prerequisites for success comprise of a qualityAmbulatory Surgical Unit (ASU), communication, and good multi-discipl<strong>in</strong>ary collaboration. The surgical technique fortonsillectomy, easily acquired by a surgeon with controlled standard and quality, is also important <strong>in</strong> our op<strong>in</strong>ion. Theselected technique for our tonsillectomy is with Bipolar Diathermy Dissection. We did not experience any case of muchfeared immediate haemorrhage with<strong>in</strong> the designed system. Three cases presented between the fourth to the seventhday with secondary haemorrhage required <strong>in</strong>tervention. They would not have benefited from a two night admission postoperation.28 cases (31%) presented to the Accident and Emergency Department (AED) predom<strong>in</strong>antly for pa<strong>in</strong> controlbetween the third to the seventh day which has been gradually addressed over time with better choices of oral analgesics.Nausea and vomit<strong>in</strong>g, the commonest problem post-tonsillectomy, were m<strong>in</strong>imal <strong>in</strong> our cases with the use of propofol,sevoflurance or total <strong>in</strong>travenous anaesthesia (TIVA) with propofol and remifentanyl or alfentanyl, plus ondansetron for nausea<strong>in</strong> anaesthesia. The patient satisfaction survey by our ASU <strong>in</strong>dicated that the majority of our patients, preferred the day casesystem and did not prefer admission to hospital. As with other rout<strong>in</strong>e ENT day cases, much resources could understandablybe saved <strong>in</strong> a Day ENT Hospital model yet the driv<strong>in</strong>g force should rema<strong>in</strong> to be patient’s comfort and satisfaction.
116HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS5.1 Modernis<strong>in</strong>g Healthcare: The Need to Change 09:00 Convention Hall BImpacts of an Age<strong>in</strong>g Population: Way Forward for Health and Social CareChan ACMAsia-Pacific Institute of Age<strong>in</strong>g Studies, L<strong>in</strong>gnan University; Elderly Commission, Hong KongPopulation age<strong>in</strong>g strikes Asia at a speed and a scale unprecedented <strong>in</strong> history. Not only the size of the older population (i.e.65+) is go<strong>in</strong>g to be the largest, older people <strong>in</strong> Japan and Hong Kong are the longest liv<strong>in</strong>g (with an average life expectancy atbirth exceed<strong>in</strong>g 86 years of age at present). Women also outlive (therefore outnumber) men for four to five years, leav<strong>in</strong>g themthe largest group <strong>in</strong> poverty as most are not covered by contributive pensions.The change to an elderly-focused (i.e. with chronic illnesses) healthcare system also requires a shift from acute curativeoperation to one that encourages health promotion and illness prevention at an early age, supported with a firm system ofcommunity rehabilitation care. Regard<strong>in</strong>g personal care service, w<strong>in</strong>n<strong>in</strong>g back the family to share the care, <strong>in</strong> particular toreplace <strong>in</strong>stitutional care, is almost impossible <strong>in</strong> many facets, <strong>in</strong>clud<strong>in</strong>g <strong>in</strong>creas<strong>in</strong>g s<strong>in</strong>gle parents, divorce and re-marriagerates, and the lack of car<strong>in</strong>g commitments as a result of <strong>in</strong>dividualism. The need for more women to enter and stay <strong>in</strong> theworkforce is also aga<strong>in</strong>st family care. What is needed first and foremost is a change of m<strong>in</strong>dset at the service delivery front –to accept that the many-help<strong>in</strong>g-hands approach (e.g. cross discipl<strong>in</strong>es and cross sectors collaborations) is the only possibleway for seamless health and social care, and ord<strong>in</strong>ary people <strong>in</strong>clud<strong>in</strong>g our relatives and neighbours (so called <strong>in</strong>formal caregivers) could provide certa<strong>in</strong> level of care to complement the highly skilled, expensive and number-limited professional caregivers (e.g. social workers, nurses, occupational therapist, physiotherapist, etc.)Thursday, 16 MayTo put ideas <strong>in</strong>to practice, <strong>in</strong>novative policy mak<strong>in</strong>g, fund<strong>in</strong>g for research and political will are required. With theencouragement from the Elderly Commission (EC), the Hong Kong government has piloted several <strong>in</strong>itiatives <strong>in</strong> this regard.The EC and the Labour and Welfare Bureau came up with an <strong>in</strong>itial policy idea on a through-tra<strong>in</strong> implementation plan,fund<strong>in</strong>gs were then obta<strong>in</strong>ed for small scale pilots for non-governmental organisations (NGOs). If it was successful, pilotswould then become policies. For example, the Elder Academies (students teach older persons self-care and computer skillswith primary and secondary schools as platforms); and the Good Neighbours series can: (1) l<strong>in</strong>k NGOs with faith-basedorganisations like churches for tra<strong>in</strong><strong>in</strong>g older volunteers; (2) l<strong>in</strong>k NGOs with tra<strong>in</strong>ed volunteers for prevention of abuses; and(3) l<strong>in</strong>k specialist medical teams to NGOs and their tra<strong>in</strong>ed volunteers for suicide prevention, as well as for hospital dischargeplann<strong>in</strong>g. Policy drivers for and implementation of these projects will be briefly discussed.S5.2 Modernis<strong>in</strong>g Healthcare: The Need to Change 09:00 Convention Hall BTackl<strong>in</strong>g Complex Chronic Conditions — Apply What We Already KnowLeung GMDepartment of Community Medic<strong>in</strong>e, The University of Hong Kong, Hong Kong“Global Burden of Disease 2010” estimates that 54% of all Disability-Adjusted Life Years (DALYs) worldwide and the top 10causes of DALYs <strong>in</strong> high-<strong>in</strong>come Asia Pacific as well as East Asia can be attributed to non-communicable diseases (NCDs).In post-modern Hong Kong, the attributable fraction due to NCDs can only be more burdensome.Whereas hospitals and by extension specialist cl<strong>in</strong>ics are the f<strong>in</strong>al common pathway for patients with NCDs, the solutionto tackl<strong>in</strong>g this burden is of course upstream along the referral cha<strong>in</strong> <strong>in</strong> primary and preventive care. Rose’s preventionparadox specifies a more nuanced but no less <strong>in</strong>tensive approach towards purveyors of processed foods as per big tobacco.It also requires pervasive attention <strong>in</strong> all policies and deliberations regard<strong>in</strong>g health impact, just as environmental impactassessments are de rigeur. Dahlgren and Whitehead’s conceptualisation of social determ<strong>in</strong>ants and Marmot’s World HealthOrganisation Commission f<strong>in</strong>d<strong>in</strong>gs <strong>in</strong>struct that root causes be identified and addressed, whereas victim blam<strong>in</strong>g mustcease. Alma Ata and Starfield’s empiricism have demonstrated the utility and economy of primary care. Screen<strong>in</strong>g shouldbe meticulously evaluated then judiciously applied accord<strong>in</strong>g to Lalonde’s “populations at risk” approach. Research mustcont<strong>in</strong>ue <strong>in</strong>to better understand<strong>in</strong>g pathogenesis as well as devis<strong>in</strong>g therapeutics.Noth<strong>in</strong>g less than a comprehensive strategy, however <strong>in</strong>crementally but systematically executed and measured, will sufficeto mitigate this complex, chronic burden of NCDs. Health and wellbe<strong>in</strong>g aside, our productivity and economy depend on itssuccess.
SymposiumsS5.3 Modernis<strong>in</strong>g Healthcare: The Need to Change 09:00 Convention Hall BChallenges Ahead <strong>in</strong> Healthcare ManagementLo SVStrategy and Plann<strong>in</strong>g Division, Hospital Authority, Hong KongChallenges faced by healthcare organisations vary <strong>in</strong> develop<strong>in</strong>g and developed economies, and <strong>in</strong> public and private serviceproviders. Yet, escalat<strong>in</strong>g cost and staff shortages are probably the greatest and most common challenges <strong>in</strong> healthcaremanagement.The Hospital Authority (HA) is the major public healthcare provider <strong>in</strong> Hong Kong. Besides the generic pressure of <strong>in</strong>creas<strong>in</strong>gcost and manpower shortage, the HA is at the same time greatly challenged by ever-<strong>in</strong>creas<strong>in</strong>g service demands. This islargely due to the fact that the HA is tasked to make available heavily subsidised services to all residents of Hong Kong sothat “no person should be prevented, through lack of means, from obta<strong>in</strong><strong>in</strong>g adequate medical treatment” <strong>in</strong> accordance withthe HA Ord<strong>in</strong>ance.The grow<strong>in</strong>g demand arises ma<strong>in</strong>ly from an age<strong>in</strong>g population. It is recognised that people require more healthcare services<strong>in</strong> old age and when this happens, they are also more likely to rely on subsidised or public healthcare services. The HA datashows that elderly patients have a higher number of admissions and longer length of hospital stay.117HOSPITAL AUTHORITY CONVENTION 2013It is projected that the number of elderly people <strong>in</strong> Hong Kong will grow by 140% and reach 2.18 million <strong>in</strong> 2031. Accord<strong>in</strong>gly,there is an immense need for the HA to build more hospitals and massively <strong>in</strong>crease bed capacity to cope with the <strong>in</strong>crease<strong>in</strong> service demand. However, land <strong>in</strong> Hong Kong is an extremely scarce resource, and the enormous manpower and costimplications would also render the stupendous build<strong>in</strong>g up of hospital capacity an unsusta<strong>in</strong>able option.Hence, besides capacity <strong>in</strong>crease, the HA is also develop<strong>in</strong>g other options to better manage grow<strong>in</strong>g demand. These <strong>in</strong>cludeadopt<strong>in</strong>g more efficient service models like ambulatory care and day surgery, and shar<strong>in</strong>g out the demand for high volumelow complexity services with appropriate care partners such as the private sector and the non-governmental organisations.Meanwhile, there is a need for the HA to further improve its services <strong>in</strong> l<strong>in</strong>e with medical advances and <strong>in</strong> response to ris<strong>in</strong>gexpectations from patients and community for more and better healthcare services.Thursday, 16 May
118HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS6.1 Credential<strong>in</strong>g and Practice Privileges 10:45 Convention Hall BCredential<strong>in</strong>g: Perspectives from the AcademyLau CSEducation Committee, Hong Kong Academy of Medic<strong>in</strong>e; Division of Rheumatology and Cl<strong>in</strong>ical Immunology, Department ofMedic<strong>in</strong>e, Li Ka Sh<strong>in</strong>g Faculty of Medic<strong>in</strong>e, The University of Hong Kong, Hong KongThe Hong Kong Academy of Medic<strong>in</strong>e (HKAM) is an <strong>in</strong>dependent <strong>in</strong>stitution with statutory power to organise, monitor, assessand accredit all medical and dental specialist tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Hong Kong. In order to ensure specialist registration compliance, theAcademy also provides and accredits cont<strong>in</strong>u<strong>in</strong>g medical education and cont<strong>in</strong>uous professional development. With recentrapid expansion of our knowledge <strong>in</strong> medic<strong>in</strong>e, technological advances and scope of service, there is also a need to set upfurther policies to uphold cl<strong>in</strong>ical governance and accountability.Medical credential<strong>in</strong>g is the process of establish<strong>in</strong>g qualifications of the medical professionals, organisational membersor organisations, and assess<strong>in</strong>g their background and competency. This has been <strong>in</strong>troduced <strong>in</strong> many western countriesfor a number of years. In some countries, it is also a practice to allow medical service providers to network with <strong>in</strong>surancecompanies. However, the ultimate purpose must be to safeguard the health of patients, <strong>in</strong> addition to enhanc<strong>in</strong>g thecredibility and quality of healthcare professionals and service providers. Medical credential<strong>in</strong>g has recently been <strong>in</strong>troducedby the Hospital Authority to def<strong>in</strong>e the scope of practice of its staff and to ma<strong>in</strong>ta<strong>in</strong> its quality of service. With<strong>in</strong> the Academy,a Work<strong>in</strong>g Group has also been set up to identify the areas for credential<strong>in</strong>g and its process. One of the first tasks is toformulate a general credential<strong>in</strong>g protocol which <strong>in</strong>cludes an <strong>in</strong>itial accreditation process, regular reviews, and remedialand appeal procedures. Concurrently, colleges are <strong>in</strong>vited to identify medical procedures and treatment which require earlyconsiderations for credential<strong>in</strong>g, and to def<strong>in</strong>e specific assessment and review processes.Thursday, 16 MayWith over 6,000 fellows work<strong>in</strong>g <strong>in</strong> various discipl<strong>in</strong>es under 15 Academy Colleges, this endeavour will be an arduous andslowly evolv<strong>in</strong>g one. This may also be compounded by the blurr<strong>in</strong>g of conventional boundaries between discipl<strong>in</strong>es withsome medical management protocols and procedures be<strong>in</strong>g practised by fellows across colleges. Nevertheless, medicalcredential<strong>in</strong>g is the right direction for the development of specialty and subspecialty medic<strong>in</strong>e <strong>in</strong> Hong Kong, and theAcademy is grateful for the support of our colleges <strong>in</strong> this effort.S6.2 Credential<strong>in</strong>g and Practice Privileges 10:45 Convention Hall BEarly Steps along Credential<strong>in</strong>g <strong>in</strong> Hong Kong — Experience of a College and Private Hospital OrganiserLeung AKLHospital Management Office, Union Hospital, Hong KongThe Hong Kong College of Obstetricians and Gynaecologists (HKCOG) conducted exercises related to accreditation ofdoctors with special experience. The first exercise was conducted on gynaecological endoscopic surgery. In gynaecologicalendoscopy, the HKCOG put forth <strong>in</strong>termediate and advanced level accreditations for doctors who perform gynaecologicallaparoscopic surgery. Case count<strong>in</strong>g on operations as surgeon was used as the pr<strong>in</strong>cipal assessment tool. An examplefrequently quoted is made with colposcopy. In colposcopy, a doctor has to perform up to a set number of exam<strong>in</strong>ationsand fulfill CME requirements before accreditation. In addition, recertification of all four subspecialists <strong>in</strong> Obstetricians andGynaecologists requires documentation. F<strong>in</strong>ally, <strong>in</strong> the past few years, HKCOG worked closely with the Royal College ofObstetricians and Gynaecologists to assess competence of tra<strong>in</strong>ees dur<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g.In the private sector, some early work on attach<strong>in</strong>g credentials to scope of service has been started. The risk profile ofdifferent treatments may also be reflected by compensation and compla<strong>in</strong>t statistics.One may argue that the new credential<strong>in</strong>g exercise could beg<strong>in</strong> with high risk and high volume management, evolv<strong>in</strong>g fromearly experience of various specialties.
SymposiumsS6.3 Credential<strong>in</strong>g and Practice Privileges 10:45 Convention Hall BCredential<strong>in</strong>g of Doctors <strong>in</strong> Private HospitalChan JWTHong Kong Sanatorium and Hospital, Hong KongWith advances <strong>in</strong> medic<strong>in</strong>e, we have witnessed a change towards specialisation and sub-specialisation of medicalpractitioners. At the same time, there appeared a great number of new procedures, both diagnostic and therapeutic, <strong>in</strong> themedical field. It has become important for a responsible and car<strong>in</strong>g healthcare organisation to make sure that our patientsare be<strong>in</strong>g managed by qualified doctors with appropriate experience.This presentation describes the process of credential<strong>in</strong>g of doctors <strong>in</strong> a private hospital, and the evolution of system as newservices offered by the hospital. The hospital has to set new policies of grant<strong>in</strong>g practice privileges when new proceduressuch as Robotic Assisted Surgery are <strong>in</strong>troduced. Systems have to be established through review and governance <strong>in</strong> order toascerta<strong>in</strong> the competence, performance and professional suitability of doctors to cont<strong>in</strong>uously provide safe and high qualityhealthcare services with<strong>in</strong> the hospital. Lessons learnt through the <strong>in</strong>corporation of the system are also discussed.119HOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 May
120HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS7.1 Partner<strong>in</strong>g with Private 13:15 Convention Hall BPublic-Private Partnerships <strong>in</strong> HealthcareBali VFortis Healthcare Limited, S<strong>in</strong>gaporePublic-private partnerships are be<strong>in</strong>g <strong>in</strong>creas<strong>in</strong>gly encouraged as part of comprehensive development across varioussectors <strong>in</strong> different parts of the world. The need to foster such arrangements is built on the hypothesis that the public sector<strong>in</strong> many areas is not able to execute or provide public goods entirely on its own <strong>in</strong> an efficient, effective and equitable mannerbecause of lack of resources and management issues. Public-private partnerships are <strong>in</strong>creas<strong>in</strong>gly seen as play<strong>in</strong>g a criticalrole <strong>in</strong> improv<strong>in</strong>g the performance of health systems worldwide, by br<strong>in</strong>g<strong>in</strong>g together the best characteristics of the publicand private sectors to improve efficiency, quality, <strong>in</strong>novation, and health impact of both private and public systems.In the past, the private and public sectors <strong>in</strong> health operated more or less <strong>in</strong>dependently <strong>in</strong> most countries. The assumptionwas that the private sector provided services mostly to the wealthy <strong>in</strong> any country, while the government served those whowere unable to pay for services. A large portion of healthcare budgets <strong>in</strong> all countries is spent on sophisticated hospital care,usually found <strong>in</strong> urban sett<strong>in</strong>gs, rather than primary care or preventive care that serves the needs of the rural. In order toadvance healthcare delivery to a larger cross section of the population, many who <strong>in</strong> the past supported a pure governmentsystem on philosophical grounds are now more will<strong>in</strong>g to consider the private sector as an <strong>in</strong>tegral part of the nationalprogramme, and f<strong>in</strong>d ways that public-private partnerships can be used to make the entire system more productive.Thursday, 16 MayAnother shift <strong>in</strong> philosophy has occurred with regard to the private sector. It is generally felt that the private sector, as aresult of the competitive environment and the subsequent need to survive, is more able to respond to change and moreable to deliver services at low cost when there is an appropriate stimulus to do so. Thus, as cost pressures and the needfor change have been <strong>in</strong>creas<strong>in</strong>gly felt by the public health sector, they have looked to the private sector both for models ofhow to deliver services more efficiently, and also as a source of <strong>in</strong>novative approaches to reach<strong>in</strong>g hard to serve population.Public-private partnerships can be an effective force toward achiev<strong>in</strong>g these results that now face health systems <strong>in</strong> Asia andaround the world and considerable work will need to be done to develop the accountability and transparency, the legal andregulatory framework, and the mutual trust that is necessary for these partnerships to succeed.Perhaps there was once a world <strong>in</strong> which the private and public sector were completely <strong>in</strong>dependent, but today that worlddoes not exist. There is probably no country <strong>in</strong> which the private sector is not deeply affected by government regulations andlaws. Similarly, almost all governments today rely on the private sector for pharmaceuticals and <strong>in</strong>creas<strong>in</strong>gly contract withprivate (often not-for-profit) organisations for tra<strong>in</strong><strong>in</strong>g; <strong>in</strong>formation, education and communication development; and often fordirect service delivery <strong>in</strong> areas where the government does not provide services. Furthermore, as government programmesmove toward social <strong>in</strong>surance programmes and contract<strong>in</strong>g mechanisms as ways to expand coverage, the <strong>in</strong>terdependenceof the public and private sectors has deepened and will need strengthen<strong>in</strong>g. The <strong>in</strong>terdependence has also made each sectorunderstand how cooperation and partnership might be mutually beneficial despite the effort that is required to ma<strong>in</strong>ta<strong>in</strong> therelationship.
SymposiumsS7.2 Partner<strong>in</strong>g with Private 13:15 Convention Hall BThe Australian Experience: The Public-Private Partnership (PPP)Russell-Weisz DJFiona Stanley Hospital Commission<strong>in</strong>g, AustraliaThroughout the world, public-private partnerships (PPPs) <strong>in</strong> the healthcare arena are be<strong>in</strong>g <strong>in</strong>troduced to vary<strong>in</strong>g degrees,<strong>in</strong>clud<strong>in</strong>g full service delivery PPPs, facility management PPPs, <strong>in</strong>frastructure PPPs and franchise PPPs. Australia has hada mixed experience over the last 20 years with PPPs, primarily <strong>in</strong> the most populated eastern States focus<strong>in</strong>g on facilitiesmanagement and <strong>in</strong>frastructure PPPs.However, <strong>in</strong> Western Australia (WA) s<strong>in</strong>ce the mid 1990s there has been significant expansion of health service PPPs primarilyof the operator led full service variety. These <strong>in</strong>clude the Joondalup Health Campus, Midland Health Campus and Peel HealthCampus – substantial and comprehensive health campuses serv<strong>in</strong>g over 60% of outer metropolitan Perth. Other healthPPPs <strong>in</strong> WA now <strong>in</strong>clude the Fiona Stanley Hospital facility management PPP, where non-cl<strong>in</strong>ical services at the new 783 bedtertiary hospital <strong>in</strong> the southern suburbs of Perth (due to open <strong>in</strong> 2014) are contracted out.Whilst there are different models for health service PPPs, the objectives are consistent – quality service whilst provid<strong>in</strong>gefficiency, <strong>in</strong>novation, better responsiveness and value for money over the term of the PPP.121HOSPITAL AUTHORITY CONVENTION 2013Challenges still abound and there rema<strong>in</strong>s a need for a balance between government’s expertise <strong>in</strong> the PPP environment, thepolitics of “privatisation” and the need to look at modalities such as PPPs that <strong>in</strong>crease quality and efficiency at the sametime. It is always salient to remember that the ultimate risk rema<strong>in</strong>s with the government.There are examples of unsuccessful PPPs <strong>in</strong> Australia, however, <strong>in</strong> WA, <strong>in</strong>stead of retraction there has been expansion.Success factors <strong>in</strong> relation to these PPPs <strong>in</strong>clude robust and detailed upfront plann<strong>in</strong>g, the right contract with early detailedpreparation, a cl<strong>in</strong>ical service delivery and not an <strong>in</strong>frastructure focus, a sound partnership between the contract managerand private provider at all levels of the respective organisations with proactive relationship management.This presentation will detail the experience <strong>in</strong> WA, concentrat<strong>in</strong>g on a significant expanded health service PPP (JoondalupHealth Campus) and a new health service PPP (Midland Health Campus), with reference to what lessons can be learnt fromthe other jurisdictions where PPPs have not had the same success.Thursday, 16 May
122HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS8.1 Optimis<strong>in</strong>g Outcomes 14:30 Convention Hall BMeasur<strong>in</strong>g Performance: Emergency Department and Surgery Wait<strong>in</strong>g Time Targets <strong>in</strong> AustraliaBennett CSchool of Medic<strong>in</strong>e, University of Notre Dame Australia, AustraliaOver the last five years, the Australian health system has been undergo<strong>in</strong>g some significant national reforms. In 2007, thehealth system was considered to be <strong>in</strong> “crisis” with ris<strong>in</strong>g pressure on public hospitals reflected by access delays, safetyand quality issues, low morale <strong>in</strong> the health workforce and ris<strong>in</strong>g community concerns which triggered a major review andnational health reform plan. A focus on emergency department safety and wait<strong>in</strong>g times and grow<strong>in</strong>g wait<strong>in</strong>g lists for <strong>book</strong>edsurgical procedures were areas of system pressure that focused by the media.The National Health Reform Agreement (February 2011) <strong>in</strong>troduced a national approach to the Australian Government’scontribution to public hospitals, which are operated by state and territory governments, based on efficient activity-basedfund<strong>in</strong>g from 2014/15. In parallel a National Health Performance Authority (NHPA) has developed measures for the hospitaland health system more generally.The relevant standards set by NHPA for emergency and surgical wait<strong>in</strong>g times are the National Emergency Access Target(NEAT) and the National Elective Surgery Target (NEST). The NEAT sets annual targets for each state and territory to achievecont<strong>in</strong>ual improvement <strong>in</strong> the proportion of emergency department presentations completed with<strong>in</strong> four hours, i.e. thepercentage of patients who, after attend<strong>in</strong>g an emergency department, are admitted to the respective hospital, referred toanother hospital, or discharged with<strong>in</strong> the four-hour timeframe. Similarly NEST targets aim to ensure that surgical patients aretreated with<strong>in</strong> their recommended cl<strong>in</strong>ical priority timeframe.Thursday, 16 MayA National Partnership Agreement fund<strong>in</strong>g arrangement has provided a specific <strong>in</strong>vestment to support improved performanceof public hospitals. The National Emergency Access Target (NEAT) and the National Elective Surgery Targets (NEST) arecomponents of the National Partnership Agreement under which states and territories have agreed to vary<strong>in</strong>g annual targetsfor 2012, 2013 and 2014.An update will be provided on the progress of these targets and their roles <strong>in</strong> the reform agenda and improv<strong>in</strong>g hospitalperformance.S8.2 Optimis<strong>in</strong>g Outcomes 14:30 Convention Hall BUse of Casemix <strong>in</strong> Cl<strong>in</strong>ical Outcome ManagementYeung DF<strong>in</strong>ance Division, Head Office, Hospital Authority, Hong KongPeriodic review of cl<strong>in</strong>ical outcome of treated patients at fixed time <strong>in</strong>tervals may fail to help doctors make “timely” decisionsto susta<strong>in</strong> quality care. Our case shows how potential values are created <strong>in</strong> improv<strong>in</strong>g cl<strong>in</strong>ical outcome from the use off<strong>in</strong>ancial casemix <strong>in</strong>formation <strong>in</strong> the Hospital Authority (HA), Hong Kong.Our advocated model Casemix Adjusted Surveillance and Early-Signall<strong>in</strong>g Management Information System (CASEMIS)br<strong>in</strong>gs three major advantages: (1) Real time comparison of actual and expected cl<strong>in</strong>ical outcome on a case-by-case basis;(2) cont<strong>in</strong>uous monitor<strong>in</strong>g and signall<strong>in</strong>g aga<strong>in</strong>st control limits for early alert and timely <strong>in</strong>tervention to rectify any trend ofdeteriorat<strong>in</strong>g cl<strong>in</strong>ical outcome; and (3) potential association of resource <strong>in</strong>formation with cont<strong>in</strong>uous cl<strong>in</strong>ical outcome trendwhich facilitates shar<strong>in</strong>g of good practice among different cl<strong>in</strong>icians to achieve the ultimate goal of better patient outcome.Casemix <strong>in</strong>formation, the International Ref<strong>in</strong>ed – Diagnosis Related Groups (IR-DRG) and correspond<strong>in</strong>g cost<strong>in</strong>g systemhave been implemented <strong>in</strong> Hong Kong public hospitals s<strong>in</strong>ce 2009. They have been used beyond the purpose of resourceallocation from 2011 onwards. We <strong>in</strong>novatively used both Casemix data and cl<strong>in</strong>ical data from the Cl<strong>in</strong>ical ManagementSystem (CMS) of the HA to build a close-to-real time cl<strong>in</strong>ical outcome monitor<strong>in</strong>g model based on the concept of cumulativesum curves with control limits.The CASEMIS has been <strong>in</strong>itially shown accurate with reasonably high predictability on mortality. This model has been appliedto monitor the mortality outcome of emergency and elective surgical cases as well as heart attack cases. Research direction<strong>in</strong> future will be on its application on monitor<strong>in</strong>g morbidity outcome.
SymposiumsS9.1 Creat<strong>in</strong>g Values 09:00 Convention Hall CThe Role of Value-based Purchas<strong>in</strong>g <strong>in</strong> United States Healthcare ReformShortell SSchool of Public Health, University of California – Berkeley, USAThis session will cover the <strong>in</strong>centives for consumers to select high quality healthcare plans and providers at affordable costand the important role to be played by transparent cost and quality data.123HOSPITAL AUTHORITY CONVENTION 2013S9.2 Creat<strong>in</strong>g Values 09:00 Convention Hall CThursday, 16 MayEvolution of Resource Allocation <strong>in</strong> Hospital Authority and the Values CreatedTse NF<strong>in</strong>ance Division, Head Office, Hospital Authority, Hong KongFor more than 20 years, Hospital Authority (HA) has been creat<strong>in</strong>g values imperative <strong>in</strong> shap<strong>in</strong>g the HA of today amidchallenges and uncerta<strong>in</strong>ties.First, to dovetail with its corporate strategy of “outcome-focused healthcare delivery”, the foremost <strong>in</strong>sight <strong>in</strong> 1990s toshift the paradigm of resource allocation from <strong>in</strong>put to output-based had laid down a pivotal cornerstone for subsequentdevelopment.The HA’s resource allocation system has s<strong>in</strong>ce moved from historical to annual plan-based that tied resource allocationto service plann<strong>in</strong>g. The revolutionary establishment of specialty cost<strong>in</strong>g and <strong>in</strong>sightful <strong>in</strong>troduction of a patient group<strong>in</strong>gmechanism had been profound.Second, the str<strong>in</strong>gent f<strong>in</strong>ancial condition s<strong>in</strong>ce early 2000 and the SARS epidemic <strong>in</strong> 2003 had led the HA to focus on servicerationalisation to better serve its community while improv<strong>in</strong>g productivity. This was endeavoured through the adoption of apopulation-based resource allocation system. Together with the altruistic professionalism, strong resilience and dedicatedteamwork, the HA had gone through catastrophic time without compromis<strong>in</strong>g its care standard.Third, <strong>in</strong> light of the age<strong>in</strong>g population, ris<strong>in</strong>g public expectation and advanc<strong>in</strong>g technology, the HA boldly implemented thePay-for-Performance (P4P) Resource Allocation Model <strong>in</strong> 2009 to promote productivity and quality improvement. Casemix<strong>in</strong>formation of <strong>in</strong>-patient services was developed to better reflect resource utilisation tak<strong>in</strong>g <strong>in</strong>to account the complexity oftreatment. The value created under the P4P regime is the awareness on performance and quality improvement throughoutthe organisation for the betterment of care.Mov<strong>in</strong>g forward, the HA needs to modernise its resource allocation to meet with challenges and uncerta<strong>in</strong>ties ahead. Acommon measurement adopt<strong>in</strong>g the concept of Total Patient Journey will be developed to facilitate more equitable resourceallocation for future service development.
124HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS10.1 Change: Why and to Where? 10:45 Convention Hall CCoord<strong>in</strong>ate My Care (CMC)Goldsman AThe Royal Marsden NHS Foundation Trust, UKThis presentation will describe a new service and technology that is be<strong>in</strong>g rolled out across London to over 3,000 patients;offer<strong>in</strong>g them choice, improved quality of life and deliver<strong>in</strong>g cost sav<strong>in</strong>gs for the National Health Service (NHS) of GBP£7,000per patient. Insights on the potential for expand<strong>in</strong>g the cl<strong>in</strong>ical use of Coord<strong>in</strong>ate My Care (CMC) beyond end of life care <strong>in</strong>toits use for long term conditions, dementia and mental health; for both UK and <strong>in</strong>ternationally, will be provided.CMC is a care plann<strong>in</strong>g system that <strong>in</strong>tegrates healthcare services with a technology platform that is accessible to ambulanceservice staff, district nurses, general practitioners <strong>in</strong>clud<strong>in</strong>g out of hours, care homes, hospices and other relevant medicalprofessionals. CMC is also the End of Life record accessed via the NHS 111 (telephone urgent care) service.The CMC service is <strong>in</strong>troduced to a patient by a cl<strong>in</strong>ician who has a clear understand<strong>in</strong>g of the patient’s medical, nurs<strong>in</strong>g andsocial history to create a record of the patient’s personalised care plan. The patient then consents to hav<strong>in</strong>g the details oftheir care plan entered onto the electronic CMC. When the patient next needs care, all those <strong>in</strong>volved <strong>in</strong> deliver<strong>in</strong>g that careknow what the patient’s wishes are and what care should be delivered, <strong>in</strong> what sett<strong>in</strong>g.Thursday, 16 MayThe service has been developed by The Royal Marsden to enable diverse health resources to be used <strong>in</strong> a more cost effectiveway. CMC is produc<strong>in</strong>g tangible benefits for cl<strong>in</strong>icians and healthcare professionals and for the patients who share their<strong>in</strong>formation with<strong>in</strong> the service. More than three-quarters of patients have achieved an improved outcome based on achiev<strong>in</strong>gtheir CMC registered choices, and on the basis of evidence from London a national rollout of CMC will deliver GBP£120m ofcost sav<strong>in</strong>gs, which is equivalent to 80 hospital wards.S10.2 Change: Why and to Where? 10:45 Convention Hall CAmbulatory Care: A Management Initiative or a Cl<strong>in</strong>ical Need?Stripp AAlfred Health, AustraliaThe process for the development of an ambulatory care service will be discussed with an emphasis on cl<strong>in</strong>ical serviceimpact, and medical and nurs<strong>in</strong>g <strong>in</strong>volvement along with the result<strong>in</strong>g cl<strong>in</strong>ical service benefits. The presentation will alsoexplore the question of whether there is a difference <strong>in</strong> management and cl<strong>in</strong>ical need regard<strong>in</strong>g the development of suchservice not<strong>in</strong>g the comb<strong>in</strong>ed imperatives and also areas of potential variance.
SymposiumsS10.3 Change: Why and to Where? 10:45 Convention Hall CHealthcare Service Remodell<strong>in</strong>g: Hong Kong ExperienceFung HNew Territories East Cluster, Hospital Authority, Hong KongWorldwide, the remodell<strong>in</strong>g of services is ga<strong>in</strong><strong>in</strong>g prom<strong>in</strong>ence <strong>in</strong> health systems to improve performance and promotepopulation health. The modernisation of health systems often <strong>in</strong>volves cl<strong>in</strong>ical restructur<strong>in</strong>g, cl<strong>in</strong>ical <strong>in</strong>tegration, care redesignand population health management. In Hong Kong, public hospitals have been organised <strong>in</strong>to clusters s<strong>in</strong>ce 2001. Thepurpose of cluster<strong>in</strong>g of public hospitals was to promote coord<strong>in</strong>ated development of hospital services to avoid gaps andduplications. In 2003, the general outpatient cl<strong>in</strong>ics were taken over. The mission of clusters was further extended to provide<strong>in</strong>tegrated healthcare for local residents. In recent years, remodell<strong>in</strong>g of cl<strong>in</strong>ical services with<strong>in</strong> the hospital clusters hasbecome more elaborated to support the plann<strong>in</strong>g and development of services and facilities. Major hospital redevelopmentsare preceded with detailed plann<strong>in</strong>g of cl<strong>in</strong>ical services development and del<strong>in</strong>eation of hospital roles. The developmentof community care and public-private partnership has also assumed important roles <strong>in</strong> the general health system. Thispresentation will review the local experiences <strong>in</strong> remodell<strong>in</strong>g of services <strong>in</strong> Hong Kong under the Hospital Authority.125HOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 May
126HOSPITAL AUTHORITY CONVENTION 2013SymposiumsS11.1 Hospital Accreditation 13:15 Convention Hall CHospital Accreditation: A Private Hospital’s ExperienceLee AHong Kong Private Hospitals Association, Hong KongIn the past two decades, hospital accreditation has been recognised worldwide as the driv<strong>in</strong>g force beh<strong>in</strong>d cont<strong>in</strong>uous qualityimprovement of healthcare systems. It should not be viewed as an exam<strong>in</strong>ation like those for higher degree qualifications, buta journey of evidence-based learn<strong>in</strong>g towards patient safety and quality customer service.As far back as 1999, the Union Hospital became the first hospital <strong>in</strong> Hong Kong to achieve <strong>in</strong>stitution-wide ISO accreditation.The ISO accredited quality management system ensured proper documentation of departmental procedures, standardwork<strong>in</strong>g guidel<strong>in</strong>es and work records. Compliance was the spirit of the exercise. To this end, an efficient team of <strong>in</strong>ternalauditors was established, whose duty was to carry out regular cross-department audits. Subsequently features of cont<strong>in</strong>uousquality improvement mechanisms with quantification were gradually added to the year 2000 and 2008 editions of the ISOstandards respectively.Next stage came the concerted effort of the Hong Kong Private Hospitals Association <strong>in</strong> <strong>in</strong>vit<strong>in</strong>g the Trent AccreditationScheme (TAS) from the United K<strong>in</strong>gdom to carry out biennial surveys for its 12 members. Thus with shar<strong>in</strong>g of <strong>in</strong>formation,benchmark<strong>in</strong>g performances and <strong>in</strong>troduc<strong>in</strong>g good practices, cont<strong>in</strong>uous quality improvement became a reality with sixrounds of survey from year 2000 to 2010.Thursday, 16 MayIn 2009, Hong Kong government <strong>in</strong>troduced the Pilot Scheme of Hospital Accreditation <strong>in</strong> close collaboration with theAustralian Council on Healthcare Standards (ACHS). In the ACHS system, cont<strong>in</strong>uous quality improvement should be of anactive nature. The hospital has to recognise its own deficiencies accord<strong>in</strong>g to def<strong>in</strong>ed functions and criteria, and it has todevise improvement measures which can be quantified with audits and eventually benchmarked <strong>in</strong>ternally or externally.Through various accreditation systems, the Union Hospital has been thriv<strong>in</strong>g along with gradual maturity of its staff andhospital culture, which accept audit and survey as a norm to the journey towards dest<strong>in</strong>ation of excellence.S11.2 Hospital Accreditation 13:15 Convention Hall CImpact of Hospital Accreditation on Public HospitalsHung CTKowloon Central Cluster, Hospital Authority, Hong KongCont<strong>in</strong>uous Quality Improvement (CQI) has become a hot topic <strong>in</strong> public hospitals <strong>in</strong> Hong Kong s<strong>in</strong>ce the formation ofHospital Authority, and the <strong>in</strong>troduction of hospital accreditation has brought new challenges and transformed the scene. Inthe past, CQI could mean just do<strong>in</strong>g a series of projects to improve quality. The impact varies because quality improvementdepends on system and culture changes. Patient safety is also an <strong>in</strong>ternational concern lately. Hospital accreditation isactualis<strong>in</strong>g CQI and address<strong>in</strong>g safety issues through build<strong>in</strong>g a robust and susta<strong>in</strong>able quality system that can stand thetest of time. The Australian Council on Healthcare Standards (ACHS) brought <strong>in</strong> the four-yearly accreditation cycle togetherwith the 13 Standards and 47 Criteria of the 5 th edition of the ACHS Evaluation and Quality Improvement Program (EQUIP5).It provides cont<strong>in</strong>uous challenges to tackle, ensur<strong>in</strong>g a systematic rather than a project-based approach <strong>in</strong> improv<strong>in</strong>g qualityand safety result<strong>in</strong>g <strong>in</strong> systematic improvement over time <strong>in</strong> all areas.A key system change brought about is on standardisation and alignment of work flow and practice. With decentralisation topromote staff empowerment and ownership <strong>in</strong> the past, variation <strong>in</strong> practice is observed that can lead to gaps and occasionalsafety issues. Through alignment of practice, reduction <strong>in</strong> variation and team work, best practice can be promoted ensur<strong>in</strong>gsafety and quality of service. Facilities are also standardised and modernised at the same time to meet current demands.Susta<strong>in</strong>ability depends on <strong>in</strong>ternalisation of values and subsequent culture changes. Hospital accreditation provides acommon quality improvement language enhanc<strong>in</strong>g communication. While the four-yearly cycle provides a constant challenge<strong>in</strong> quality improvement, each of these can become a small project by itself and provides opportunities for engag<strong>in</strong>g,motivat<strong>in</strong>g, transform<strong>in</strong>g staff and encourag<strong>in</strong>g team work. This enhances the sense of belong<strong>in</strong>g. Staff members take pride<strong>in</strong> the organisation. This motivates staff which is important to <strong>in</strong>ternalise values and consolidate subsequent culture changes.While the impact on public hospitals is very positive, the resource availability has to be part of the equation especially forthose hospitals where the gap is significant. Standardisation of practice, upgrad<strong>in</strong>g or modernisation of facilities wouldrequire manpower and fiscal resources. Despite the resource considerations, the overall cost effectiveness is high.
SymposiumsS12.1 Partner<strong>in</strong>g with Community 14:30 Convention Hall CPartnership for Mental HealthYau SNew Life Psychiatric Rehabilitation Association, Hong KongEstablished <strong>in</strong> 1965, New Life Psychiatric Rehabilitation Association strives to promote mental wellness for persons <strong>in</strong>recovery of mental illness and for their families and the general public with the ultimate goal of equal opportunities, social<strong>in</strong>clusion, acceptance and full participation <strong>in</strong> the community.To achieve this goal, the Association has been collaborat<strong>in</strong>g with different community partners to deliver recovery-orientedand evidence-based community mental health services as well as to run social enterprises.The presentation will focus on different <strong>in</strong>itiatives launched by the Association recently <strong>in</strong>clud<strong>in</strong>g the “re-brand<strong>in</strong>g campaign”with the aim to uplift the image of her social enterprises, products and services. The Association took a new <strong>in</strong>itiative topartner with local designers on the rebrand<strong>in</strong>g exercise two years ago. A new umbrella brand of “330” was created, whichwas consonant with “body-m<strong>in</strong>d-spirit” <strong>in</strong> Cantonese, echo<strong>in</strong>g the Association’s core direction of help<strong>in</strong>g the public achieve ahealthy body, m<strong>in</strong>d and spirit. The exercises started from nam<strong>in</strong>g to corporate identity and design <strong>in</strong>clud<strong>in</strong>g logo, packag<strong>in</strong>g,shop, collaterals etc., br<strong>in</strong>g<strong>in</strong>g a refresh<strong>in</strong>g look and feel to the social enterprises. The rebrand<strong>in</strong>g exercise was alsoextended to the self-brand products produced by the Association’s sheltered workshops and New Life Farm. Furthermore,the rebrand<strong>in</strong>g exercises provided an opportunity for the Association to review and renew <strong>in</strong>ternal operat<strong>in</strong>g procedures <strong>in</strong>order to realise the importance of “<strong>in</strong>side out”. The new brands had been ga<strong>in</strong><strong>in</strong>g attention and recognition <strong>in</strong> the sector. TheAssociation is now runn<strong>in</strong>g a few social enterprises <strong>in</strong> different hospitals of the Hospital Authority.127HOSPITAL AUTHORITY CONVENTION 2013S12.2 Partner<strong>in</strong>g with Community 14:30 Convention Hall CThursday, 16 MayPartner<strong>in</strong>g for Healthcare — What Can We Do for the Best of the CommunityChan IYPHealth and Care Service Department, Hong Kong Red Cross, Hong KongThe synergy of the 40-year venture between Hong Kong Red Cross and Hospital Authority (formerly partnered with Medicaland Health Department) br<strong>in</strong>gs “Patient Concern Service” (PCS) from the community to hospital, it also promotes social<strong>in</strong>tegration and recovery from hospital to community. The PCS <strong>in</strong>cludes Patient Library Service; Patient Car<strong>in</strong>g <strong>Programme</strong>;Patient Companion and Escort; Mobility Equipment Loan and Discharged Patient Care services, aim<strong>in</strong>g at provid<strong>in</strong>g apsychosocial support platform for patients who require long hospitalisation, and improv<strong>in</strong>g the discharged patients’ generalwell be<strong>in</strong>gs while back to the community. The viability of this partnership is based on the backup of health professionalsand the frontier of Red Cross volunteers. Rid<strong>in</strong>g on such collaboration, potential development of psycho-social support foremergency response will serve as another horizon for us to do more for the best of the community.
128SymposiumsHOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MayS12.3 Partner<strong>in</strong>g with Community 14:30 Convention Hall CPartnership for Community Wellness — Experience Shar<strong>in</strong>g <strong>in</strong> Collaboration between the Medical and SocialWelfare SectorYiu ITLTung Wah Group of Hospitals, Hong KongStepp<strong>in</strong>g <strong>in</strong>to the 21 st century, the rapidly age<strong>in</strong>g population has brought ever-<strong>in</strong>creas<strong>in</strong>g demand for healthcare services. Asone of the very important and primary public services that the general public has high expectation of, there need to be otherless costly but same effective alternatives to meet the ris<strong>in</strong>g service demands, without overload<strong>in</strong>g the public expenditure.The social welfare operators have ga<strong>in</strong>ed much experience and expertise <strong>in</strong> provid<strong>in</strong>g community care and support services,adopt<strong>in</strong>g a community-based, family-centred approach to meet different service needs. With this background, there areample opportunities for the Hospital Authority (HA) and non-governmental organisations to form strategic partnership, jo<strong>in</strong><strong>in</strong>ghands together to enhance primary healthcare services and to render aftercare and support services to patients and theircarers, other than <strong>in</strong>stitutionalised services.With a long established tradition of medical and social welfare services, Tung Wah Group of Hospitals has all along beenuphold<strong>in</strong>g the mission “to heal the sick and to relieve the distressed; to care for the elderly and to rehabilitate the disabled”.We have closely cooperated with the medical sector and never a new team player to the HA. We have been support<strong>in</strong>g theHA for long with part of our funds raised for the Samaritan Fund of the HA to help relieve the f<strong>in</strong>ancial difficulties of patients <strong>in</strong>need, apart from many other supports to the HA’s new healthcare <strong>in</strong>itiatives like the Patients Empowerment <strong>Programme</strong>, theIntegrated Discharge Support <strong>Programme</strong> for Elderly Patients and the Ch<strong>in</strong>ese Medic<strong>in</strong>e Centres. On the other hand, the HAhas also supported Tung Wah by render<strong>in</strong>g medical and specialist support <strong>in</strong> many medical and community health projectslike the Dementia Care Project and Alcohol Abuse Treatment <strong>Programme</strong>. Start<strong>in</strong>g from these mean<strong>in</strong>gful experiences, closercollaboration or jo<strong>in</strong>t venture between the medical and social welfare sector to meet exist<strong>in</strong>g service gaps will be furtherexplored.
MasterclassesMC1.1 Recent Surgical Developments 9:00 Theatre 1Apply<strong>in</strong>g Variable Life Adjusted Display (VLAD) <strong>in</strong> Monitor<strong>in</strong>g Surgical Operation PerformanceYuen AWCDepartment of Surgery, Ruttonjee and Tang Shiu K<strong>in</strong> Hospitals, Hong KongHospital Authority has implemented the Surgical Outcomes Monitor<strong>in</strong>g and Improvement <strong>Programme</strong> <strong>in</strong> all surgicaldepartments of 17 hospitals s<strong>in</strong>ce 2008. Under this <strong>Programme</strong>, hospitals are benchmarked by the risk-adjusted outcomes30 days after operations. The results are summarised by an observed/expected ratio (O/E) and its confidence <strong>in</strong>terval.Hospitals will be labelled as outlier if the confidence <strong>in</strong>terval is away from 1.The variable Life-adjusted Display (VLAD) was <strong>in</strong>troduced <strong>in</strong> the analytic report 2011/12. The VLAD is a plot that shows thecumulative difference between expected and actual mortality. Every case is plotted from left to right on a horizontal axis.Basically, the l<strong>in</strong>e moves up for survivors and down for deaths. For each patient who survives, the plot ascends by an amountequal to the estimated probability of death. For an <strong>in</strong>-hospital death, the plot descends by an amount equal to the estimatedprobability of survival. It shows the history of performance.By exam<strong>in</strong><strong>in</strong>g VLAD, hospitals know their variation of performance with time. In other words, hospital knows which period itperformed better and which period it performed worse. It helps hospitals identify areas of improvement. VLAD can be usedto f<strong>in</strong>d out the potential outlier. If the curve <strong>in</strong> VLAD is go<strong>in</strong>g steadily downward though deterioration is not up to the po<strong>in</strong>tbeyond control limit, hospital can be alerted to start improvement process.129HOSPITAL AUTHORITY CONVENTION 2013In this presentation, the concept and application will be discussed with examples from different hospitals.MC1.2 Recent Surgical Developments 09:00 Theatre 1Thursday, 16 MayBe a Happy Lady — How Urologists HelpCheung EHYSurgery Department, North District Hospital, Hong KongFemale ur<strong>in</strong>ary <strong>in</strong>cont<strong>in</strong>ence is a worldwide problem. The prevalence is about 20%. However several factors will lead to<strong>in</strong>creased risk, which <strong>in</strong>clude pregnancy, obesity, diabetes, and ag<strong>in</strong>g. By estimation, around one-third of women over 50may have ur<strong>in</strong>ary <strong>in</strong>cont<strong>in</strong>ence.The first l<strong>in</strong>e treatment is non-surgical treatment, which <strong>in</strong>clude pelvic floor exercise, bladder tra<strong>in</strong><strong>in</strong>g, and good dr<strong>in</strong>k<strong>in</strong>g andvoid<strong>in</strong>g habit. Cure rate for women with mild symptoms is about 80%.However <strong>in</strong> Hong Kong, public awareness for female ur<strong>in</strong>ary <strong>in</strong>cont<strong>in</strong>ence is very low. From the statistics of our study, over77.8% women would not seek any medical advice with the ma<strong>in</strong> reason of wrong perception. Most women considered itwas normal when gett<strong>in</strong>g old, so there was no need to seek medical advice; some considered it was too mild so they did notbother; and some did not know where to seek medical advice.From urologist’s perspective, prevention and early treatment is the golden rule for this problem. We actively promote themessage of “treat early is better” to the public. We hold regular health talk every year; prepare education pamphlet, video,website; and we also share real stories from our patients <strong>in</strong> Jade channel <strong>in</strong> 2012. In addition, we have a nurse led fast tractcl<strong>in</strong>ic which offers early treatment for patients.For surgery, besides the gold standard of ord<strong>in</strong>ary mid urethral sl<strong>in</strong>g, we also have homemade sl<strong>in</strong>g for the poor and spiralsl<strong>in</strong>g as salvage procedures for recurrent cases.In summary, urologists just like urogynaecologists, who offer surgical treatment, also focus on prevention and earlytreatment. we hope to make our ladies happy.
130HOSPITAL AUTHORITY CONVENTION 2013MasterclassesMC1.3 Recent Surgical Developments 09:00 Theatre 1Concerted Effort <strong>in</strong> Care of Female Ur<strong>in</strong>ary Incont<strong>in</strong>ence and Pelvic Organ ProlapseChan SSCDepartment of Obstetrics and Gynaecology, Pr<strong>in</strong>ce of Wales Hospital, Hong KongPelvic floor disorders, namely ur<strong>in</strong>ary <strong>in</strong>cont<strong>in</strong>ence and pelvic organ prolapse, are prevalent <strong>in</strong> middle aged and elderlywomen. Ch<strong>in</strong>ese validated Urogenital Distress Inventory and Incont<strong>in</strong>ence Impact Questionnaire short form, and Pelvic FloorDistress Inventory and Pelvic Floor Impact Questionnaire have been available for use locally <strong>in</strong> the past few years. Apart fromdistress caused by symptoms, women suffer<strong>in</strong>g from these conditions also have impaired quality of life (QOL).Our urogynaecology service is provided by both Nurse Cont<strong>in</strong>ence Advisors and Urogynaecologists Cont<strong>in</strong>ence Advisorswho educate patients muscle tra<strong>in</strong><strong>in</strong>g, bladder drill<strong>in</strong>g and void<strong>in</strong>g habit. Pelvic floor muscle tra<strong>in</strong><strong>in</strong>g has been shown to bean effective first-l<strong>in</strong>e <strong>in</strong>tervention for improv<strong>in</strong>g ur<strong>in</strong>ary symptoms and QOL of women present<strong>in</strong>g with ur<strong>in</strong>ary <strong>in</strong>cont<strong>in</strong>ence,irrespective of different urodynamic diagnoses. Accord<strong>in</strong>g to our prospective observational study, tension-free-transvag<strong>in</strong>altape surgery, either retropubic or transobturator approach, has been shown to achieve high efficacy <strong>in</strong> manag<strong>in</strong>g women’surodynamic stress <strong>in</strong>cont<strong>in</strong>ence <strong>in</strong> both short and long term.Thursday, 16 MayVag<strong>in</strong>al r<strong>in</strong>g pessary is a common treatment option for women suffered from pelvic organ prolapse. A tra<strong>in</strong><strong>in</strong>g programme forCont<strong>in</strong>ence Advisor on vag<strong>in</strong>al r<strong>in</strong>g pessary replacement for women has been implemented <strong>in</strong> New Territories East Clusters<strong>in</strong>ce 2009. Women are also encouraged to learn self-replacement. Vag<strong>in</strong>al hysterectomy and pelvic floor repair surgeryrema<strong>in</strong> to be the most common surgical options for mild degree of uter<strong>in</strong>e prolapse. Vag<strong>in</strong>al mesh repair surgery is offeredwhen women have advanced degree of prolapse. S<strong>in</strong>ce April 2012, it has been a medical device funded by the HospitalAuthority (HA). An audit on the use of vag<strong>in</strong>al mesh and long term outcome throughout all obstetrics and gynaecology units<strong>in</strong> the HA is ongo<strong>in</strong>g. Laparoscopic sacrocolpopexy, with medium term outcome comparable to overseas’ series, is an optionfor women with vag<strong>in</strong>al vault prolapse. Laparoscopic hysterocolposacropexy is a relatively new modality for women whowant to conserve the uterus.
MasterclassesMC2.1 New Frontiers <strong>in</strong> Medic<strong>in</strong>e 10:45 Theatre 1Percutaneous Coronary Intervention — Past, Present and FutureChiang CSMedic<strong>in</strong>e Department, Queen Elizabeth Hospital, Hong KongIn modern era, reperfusion therapy has become the ma<strong>in</strong>stay treatment for patients suffer<strong>in</strong>g from severe ischemic heartdisease. S<strong>in</strong>ce Dr. Andreas Grüntzig first successfully performed percutaneous translum<strong>in</strong>al coronary angioplasty (PTCA) <strong>in</strong>1977, transcatheter-based reperfusion therapy has ga<strong>in</strong>ed much popularity. At present, percutaneous coronary <strong>in</strong>tervention(PCI) has replaced coronary artery bypass surgery (CABG) as the most common method of coronary artery reperfusion.Compared to CABG, the ma<strong>in</strong> drawback of PTCA us<strong>in</strong>g simple balloon <strong>in</strong>flation is the high rate of restenosis. The underly<strong>in</strong>gmechanisms for restenosis are arterial recoil, negative remodel<strong>in</strong>g and neo-<strong>in</strong>timal hyperplasia. Intracoronary stent<strong>in</strong>g cansolve the problem of arterial recoil and negative remodel<strong>in</strong>g by its scaffold<strong>in</strong>g effect and has significantly reduced the rate ofrestenosis after PCI. However, <strong>in</strong>stent restenosis (ISR) still occurs due to neo-<strong>in</strong>timal hyperplasia. Drug elut<strong>in</strong>g stents (DES)eventually emerged as an effective preventive strategy for restenosis and ISR. DES comb<strong>in</strong>es the pr<strong>in</strong>ciple of mechanicalscaffold<strong>in</strong>g (stent) with that of local pharmacological action (drug) and has substantially reduced the rate of ISR from 30% to9%. At present, <strong>in</strong>tracoronary stent<strong>in</strong>g us<strong>in</strong>g DES has been the most popular mode of PCI.131HOSPITAL AUTHORITY CONVENTION 2013In 2011, a novel method of PCI has appeared: bioresorbable vascular scaffold (BVS). It is often regarded as the fourthrevolution <strong>in</strong> PCI technology. BVS is similar <strong>in</strong> appearance to a stent, but is a non-metallic, non-permanent mesh implant.BVS gradually dissolves from a few months after implantation, potentially allow<strong>in</strong>g the coronary artery to function naturallyaga<strong>in</strong>. Instead of metal, BVS is made of a bioresorbable polymer called polylactide (PLA). PLA has been widely used <strong>in</strong>medical device applications s<strong>in</strong>ce the 1960s. It will be metabolised <strong>in</strong>to water and carbon dioxide. The potential advantagesof BVS are to restore natural vessel movement and response. Future re-<strong>in</strong>tervention (PCI and CABG) is unobstructed,allow<strong>in</strong>g simplified follow-up with non-<strong>in</strong>vasive diagnostic imag<strong>in</strong>g (MR/CT). At present, the ABSORB trial of BVS with 131patients showed promis<strong>in</strong>g results with efficacy and safety profiles similar to DES. ABSORB EXTEND trial is an ongo<strong>in</strong>gcl<strong>in</strong>ical trial with 1,000 patients which will further ascerta<strong>in</strong> the efficacy and safety of BVS.MC2.2 New Frontiers <strong>in</strong> Medic<strong>in</strong>e 10:45 Theatre 1Thursday, 16 MayHeart Transplantation and Ventricular Assist Device (VAD) TherapyAu TWKDepartment of Cardiothoracic Surgery, Queen Mary Hospital, Hong KongThe first successful heart transplantation <strong>in</strong> Hong Kong was carried out at the Grantham Hospital <strong>in</strong> 1992 by Professor CKMok and Doctor SW Chiu. Up till now, over 140 heart transplantations have been performed with actuarial survival rate of82% and 58% <strong>in</strong> five years and 10 years respectively. Nowadays, heart transplantation cont<strong>in</strong>ues to be the gold standardtreatment for end stage heart failure. However, the upsurge of more critically ill patients, <strong>in</strong>creas<strong>in</strong>g prevalence of end stageheart failure and scarcity of donor organs have made mechanical circulatory support such as ventricular assist device a lifesav<strong>in</strong>galternative especially when patients are <strong>in</strong> refractory cardiogenic shock with progress<strong>in</strong>g multiple organs failure.In 2010, the Cardiothoracic Transplant Team at the Queen Mary Hospital <strong>in</strong>troduced the Left Ventricular Assist Device (LVAD)programme as a bridge to transplant therapy. S<strong>in</strong>ce then, n<strong>in</strong>e patients were successfully implanted with the device. Togetherwith the untir<strong>in</strong>g effort to promote organ donations by the community and the Hospital Authority, it is expected that mortalityand morbidity for patients with end stage heart failure <strong>in</strong> future will decrease. However, we are still fac<strong>in</strong>g many obstacles andquestions such as the optimal size and design of the device, its durability, expensive cost, optimal duration of support, idealtim<strong>in</strong>g to bridge to transplant or to other longer term device, device-related complications, and whether the future devicecould be a viable alternative to heart transplantation.
132MasterclassesHOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MayMC2.3 New Frontiers <strong>in</strong> Medic<strong>in</strong>e 10:45 Theatre 1Improvement of Cure Rate <strong>in</strong> Childhood Acute Lymphoblastic Leukaemia: No New Drugs <strong>in</strong> the Past ThreeDecadesLi CKDepartment of Paediatrics, Pr<strong>in</strong>ce of Wales Hospital, Hong KongAcute lymphoblastic leukaemia (ALL) is the commonest childhood malignancy, which accounted for about 25% of allchildhood cancers. In Hong Kong, there are about 30 to 40 new cases every year. The treatment of ALL by chemotherapystarted as early as 1940s with limited success; only transient remission could be achieved. S<strong>in</strong>ce 1970s, there wasremarkable improvement <strong>in</strong> cure rate after <strong>in</strong>troduction of new cytotoxic drugs and cranial irradiation. The long term eventfreesurvival (EFS) <strong>in</strong>creased from 20% to 65% <strong>in</strong> 10 years. From 1980 onward, there has been progressive improvement ofEFS to over 80%, and the overall survival rate is now approach<strong>in</strong>g 90%. However there is no new chemotherapeutic agent<strong>in</strong>troduced for ALL frontl<strong>in</strong>e treatment <strong>in</strong> the past three decades.The success of ALL treatment is based on collaborative work among paediatric oncologists and also the contribution frompatients and their parents. In US, over 90% of all newly diagnosed ALL children is recruited <strong>in</strong>to national based researchprotocols. Similarly <strong>in</strong> many countries of Europe such as United K<strong>in</strong>gdom and Germany, there are also many national basedALL research studies. In Hong Kong, we also started research protocols <strong>in</strong>volv<strong>in</strong>g all children cancer units s<strong>in</strong>ce 1993.Through the collaborative work with large sample size, the <strong>in</strong>vestigators could test the hypothesis through randomisedcontrol studies and also develop new technologies <strong>in</strong> diagnosis and disease monitor<strong>in</strong>g. With better understand<strong>in</strong>g of thegenetic basis, the most appropriate treatment strategy can be devised. We learn how to use the anti-leukaemia drugs wiselyand properly. Introduction of delayed <strong>in</strong>tensification (repeat of <strong>in</strong>duction chemotherapy) at four to five months after diagnosisimproves survival by 10% to 20%. Change of steroid from prednisone to dexamethasone has seen 10% improvement <strong>in</strong>survival rate. With the improvement <strong>in</strong> cure rate and long term survivors on the rise, we also learn to limit toxic treatment toreduce long term complications. We are now <strong>in</strong> the era of tailor<strong>in</strong>g treatment accord<strong>in</strong>g to <strong>in</strong>dividual biological characteristicsand treatment response. We aim at achiev<strong>in</strong>g >90% long term survival with m<strong>in</strong>imal or no late sequelae.
MasterclassesMC3.1 Creat<strong>in</strong>g a Positive Environment: Build<strong>in</strong>g a Magnet Hospital 13:15 Theatre 1Build<strong>in</strong>g a Magnet Nurs<strong>in</strong>g Department: The Mount S<strong>in</strong>ai Medical Centre ExperiencePorter CThe Mount S<strong>in</strong>ai Medical Centre, USAThe Mount S<strong>in</strong>ai Hospital <strong>in</strong> New York City has been designated as an American Nurs<strong>in</strong>g Credential<strong>in</strong>g Centre (ANCC)Magnet Hospital s<strong>in</strong>ce 2004, re-designated <strong>in</strong> 2009 and prepar<strong>in</strong>g for re-designation review once aga<strong>in</strong> <strong>in</strong> 2013. Thispresentation will focus on the progression and enculturation of the components and standards of the Magnet <strong>Programme</strong>at Mount S<strong>in</strong>ai over the past n<strong>in</strong>e years. A review of the literature will be presented on establish<strong>in</strong>g a dynamic Magnetenvironment and the result<strong>in</strong>g effect on patient care, quality/patient safety and establish<strong>in</strong>g a positive nurs<strong>in</strong>g practiceenvironment as a basis for ongo<strong>in</strong>g improvement <strong>in</strong> patient and family experience of care. The <strong>in</strong>clusion of cl<strong>in</strong>ical nurses <strong>in</strong>decision mak<strong>in</strong>g and guid<strong>in</strong>g their own practice has resulted <strong>in</strong> the establishment of The Mount S<strong>in</strong>ai Hospital RelationshipCentred Care Model. It is <strong>in</strong>troduced and led by nurs<strong>in</strong>g and now expanded across the entire medical centre, <strong>in</strong>clud<strong>in</strong>g allstaff that <strong>in</strong>teract with patients and families. It is an example of an empowered nurs<strong>in</strong>g workforce provid<strong>in</strong>g <strong>in</strong>novative care.The Magnet <strong>Programme</strong> enhances collaboration between management, all levels of nurses and the <strong>in</strong>terdiscipl<strong>in</strong>ary team.Empower<strong>in</strong>g frontl<strong>in</strong>e staff to be transformational <strong>in</strong> their practice is a key element which thrives <strong>in</strong> the Magnet culture.Cl<strong>in</strong>ical challenges and selected examples of improvements <strong>in</strong> quality outcomes and <strong>in</strong>novative nurs<strong>in</strong>g practice will bepresented.133HOSPITAL AUTHORITY CONVENTION 2013MC3.2 Creat<strong>in</strong>g a Positive Environment: Build<strong>in</strong>g a Magnet Hospital 13:15 Theatre 1Thursday, 16 MayThe Academic Perspective on Creat<strong>in</strong>g a Positive Practice EnvironmentFitzpatrick JCase Western Reserve University, USAThis presentation will focus on ways <strong>in</strong> which the academic and service sectors partnered to develop and implement aprofessional practice environment at a major medical centre. Two key aspects of the partnership will be highlighted: (1)del<strong>in</strong>eation of the relationship between pr<strong>in</strong>ciples and concepts of Purposeful and Intentional Professional Nurs<strong>in</strong>g Practice,the American Nurses’ Association (ANA) Standards of Professional Nurs<strong>in</strong>g Practice and Professional Nurs<strong>in</strong>g Performance;and (2) exemplary research projects focused on the Professional Practice Model (PPM) outcomes for nurses and patients. Inrelation to PPM, the theoretical model underly<strong>in</strong>g the current work of Relationship-based Care (RBC) will be described.The presentation will <strong>in</strong>clude def<strong>in</strong><strong>in</strong>g Purposeful and Intentional Professional Nurs<strong>in</strong>g Practice; the theoretical model ofRelationship-based Care (RBC), the ANA Standards of Practice and Professional Performance. Exemplars for selectedstandards will be presented, with focus on how RBC was used to guide the nurs<strong>in</strong>g practice. The presentation goals are asfollows: (1) To present a clear understand<strong>in</strong>g of professional nurs<strong>in</strong>g practice and RBC and their <strong>in</strong>tegration <strong>in</strong> extant nurs<strong>in</strong>gpractice; (2) to provide a roadmap for implement<strong>in</strong>g the Standards of Practice <strong>in</strong>to daily professional practice; and (3) topresent a practical approach for us<strong>in</strong>g theory <strong>in</strong> cl<strong>in</strong>ical practice. Research on nurses car<strong>in</strong>g behaviours and their relationshipto patient outcomes, <strong>in</strong>clud<strong>in</strong>g patient satisfaction will be presented. The various strategies for enhanc<strong>in</strong>g academic servicepartnerships will also be identified.
134MasterclassesMC3.3 Creat<strong>in</strong>g a Positive Environment: Build<strong>in</strong>g a Magnet Hospital 13:15 Theatre 1Build<strong>in</strong>g a Magnet Hospital – Local PerspectiveFung SFormer Chief Manager (Nurs<strong>in</strong>g), Hospital Authority, Hong Kong“Happy Staff” is one of the four missions of the Hospital Authority (HA). Faced with nurs<strong>in</strong>g manpower shortage and loom<strong>in</strong>gpatient volume, nurses are work<strong>in</strong>g under <strong>in</strong>tense pressure. Improv<strong>in</strong>g nurses’ practice environment is an <strong>in</strong>itiative to boostthe morale as well as to improve the quality of patient care at the bedside.A bottom-up approach has been adopted as problem identification and problem solv<strong>in</strong>g methodologies. The aims <strong>in</strong>cludeimprov<strong>in</strong>g morale and job satisfaction of ward staff; enhanc<strong>in</strong>g collaborative teamwork, process redesign and othermeasures; care process streaml<strong>in</strong><strong>in</strong>g, and improv<strong>in</strong>g work efficiency and service quality. Staff mix review and workforcereform are <strong>in</strong>strumental <strong>in</strong> releas<strong>in</strong>g nurs<strong>in</strong>g time for provid<strong>in</strong>g quality and timely direct patient care. Modernisation of patientcare equipment and facilities such as smart <strong>in</strong>fusion pump, alarm pad, bladder scanner, communication system are examplesto address difficulties <strong>in</strong> daily operations.Representatives from seven clusters under the HA have been nom<strong>in</strong>ated by the Cluster Manager (Nurs<strong>in</strong>g) to coord<strong>in</strong>ateworks among the cluster hospitals. Colleagues of procurement departments and facility management were <strong>in</strong>strumental <strong>in</strong>support<strong>in</strong>g and advis<strong>in</strong>g on purchase and construction works. Evaluation report showed that job satisfaction and sense ofbelong<strong>in</strong>g of nurses have been enhanced. The quality of patient services was also improved. In conclusion, positive workenvironment will also br<strong>in</strong>g a positive impact on patient care outcomes.Thursday, 16 MayHOSPITAL AUTHORITY CONVENTION 2013
MasterclassesMC4.1 Toxicology Services 14:30 Theatre 1Outbreaks of HypoglycaemiaMak THospital Authority Toxicology Reference Laboratory (TRL), Pr<strong>in</strong>cess Margaret Hospital, Hong KongSulphonylureas are oral hypoglycaemic agents (OHA). They can <strong>in</strong>duce prolonged and profound hypoglycaemia, particularly<strong>in</strong> non-diabetics. There were three outbreaks of such poison<strong>in</strong>g <strong>in</strong> Hong Kong s<strong>in</strong>ce the formation of the Hong Kong PoisonControl Network.The first outbreak occurred <strong>in</strong> May 2005. A number of non-diabetic patients were admitted to different hospitals withunexpla<strong>in</strong>ed hypoglycaemia. TRL confirmed that gliclazide was the cause. Contact trac<strong>in</strong>g revealed that this cluster ofpatients was seen by the same general practitioner who dispensed gliclazide <strong>in</strong> lieu of simethicone to more than 100 patients.Five patients died dur<strong>in</strong>g hospitalisation; two were given a verdict of death by misadventure by the Coroner’s Court.After the first outbreak, awareness of OHA-<strong>in</strong>duced hypoglycaemia <strong>in</strong> non-diabetics was heightened. From June 2005 toMarch 2006, TRL confirmed 23 <strong>in</strong>dependent sulphonylureas-<strong>in</strong>duced hypoglycaemia cases. These were medication errors ofvarious k<strong>in</strong>ds. Drug adm<strong>in</strong>istration errors <strong>in</strong> residential care homes for the elderly attracted most attention, which stimulatedthe formation of a multidiscipl<strong>in</strong>ary work<strong>in</strong>g group to improve drug adm<strong>in</strong>istration standard.135HOSPITAL AUTHORITY CONVENTION 2013The third outbreak occurred <strong>in</strong> late 2007 lasted for more than two years. More than 70 middle to old aged non-diabeticmale patients were admitted to various hospitals. All patients denied tak<strong>in</strong>g any medication before admission. However,glibenclamide were found <strong>in</strong> these patients’ ur<strong>in</strong>e specimens. Followup <strong>in</strong>vestigations confirmed that these patients hadtaken various k<strong>in</strong>ds of unregistered sexual enhancement products conta<strong>in</strong><strong>in</strong>g sildenafil, which were contam<strong>in</strong>ated byglibenclamide. Three patients died, one rema<strong>in</strong>ed <strong>in</strong> vegetative state and one suffered from cognitive impairment.There is a myriad of aetiologies for hypoglycaemia. Un<strong>in</strong>tentional OHA poison<strong>in</strong>g is particularly difficult to trace. Whilst anaffirmative diagnosis is important for management of <strong>in</strong>dividual patient, other potential victims may be affected when there isa systematic error. A system to detect and control such poison<strong>in</strong>g is important.MC4.2 Toxicology Services 14:30 Theatre 1Thursday, 16 MayOngo<strong>in</strong>g Poison<strong>in</strong>g Issues <strong>in</strong> Hong KongWong SMRPoison Control Centre, Department of Medic<strong>in</strong>e and Therapeutics, Pr<strong>in</strong>ce of Wales Hospital, Hong KongIn Hong Kong, there are about 400 to 600 people killed and 4,000 to 5,000 people hospitalised every year due to poison<strong>in</strong>g.Some poison<strong>in</strong>g issues cont<strong>in</strong>ued to occur <strong>in</strong> our population.Adulterants commonly identified <strong>in</strong> proprietary slimm<strong>in</strong>g products <strong>in</strong>clude appetite suppressants (e.g. sibutram<strong>in</strong>e,fenfluram<strong>in</strong>e), animal thyroid tissue, laxatives (e.g. phenolphthale<strong>in</strong>) and drugs to mask the undersirable effects of otheradulterants (e.g. propranolol). The adulterants often produce numerous side effects. For example, an association betweenthe use of “herbal slimm<strong>in</strong>g products” adulterated with sibutram<strong>in</strong>e or its structurally related analogs and psychosis has beenreported <strong>in</strong> Hong Kong recently.Tak<strong>in</strong>g Ch<strong>in</strong>ese medic<strong>in</strong>es is common among general public <strong>in</strong> Hong Kong. It is generally considered that Ch<strong>in</strong>ese herbalmedic<strong>in</strong>es are safe because they are natural <strong>in</strong> orig<strong>in</strong> but some herbs are <strong>in</strong>herently toxic and may cause severe adverseevents. Aconit<strong>in</strong>e poison<strong>in</strong>g result<strong>in</strong>g from improper <strong>in</strong>take of Ch<strong>in</strong>ese herbs conta<strong>in</strong><strong>in</strong>g aconitum alkaloids is one of the mostcommon herbs related poison<strong>in</strong>gs encountered <strong>in</strong> Hong Kong. In some of these cases, aconite herb was not prescribed anddiagnos<strong>in</strong>g “hidden” aconite poison<strong>in</strong>g can be a cl<strong>in</strong>ical challenge. In addition, confusion of herbs with toxic species has alsooccurred repeatedly <strong>in</strong> Hong Kong.Proprietary Ch<strong>in</strong>ese medic<strong>in</strong>es have also been commonly used among people <strong>in</strong> Hong Kong. Some of these products,especially when they were obta<strong>in</strong>ed from unreliable sources or outside Hong Kong, may be adulterated with westerndrugs, e.g. corticosteroids, non-steroidal anti-<strong>in</strong>flammatory drugs (NSAIDs) and diuretics. Patients may not be aware of the<strong>in</strong>gredients and resulted <strong>in</strong> significant harmful effects.These poison<strong>in</strong>g cont<strong>in</strong>ue to pose significant problems <strong>in</strong> the community. It is imperative that medical staffs are able torecognise the problems and provide appropriate management.
136HOSPITAL AUTHORITY CONVENTION 2013MasterclassesMC4.3 Toxicology Services 14:30 Theatre 1Toxico<strong>in</strong>telligence — Prepar<strong>in</strong>g for the Expected and Unexpected Poison<strong>in</strong>gsTse MLHong Kong Poison Information Centre, Hospital Authority, Hong KongPoison<strong>in</strong>g happens when a substance <strong>in</strong>side a victim’s body subsequently do some harm. We have reasonable knowledgeon poison<strong>in</strong>gs that have already happened, thanks to the <strong>in</strong>formation technology and the small <strong>in</strong>ternational community ofcl<strong>in</strong>ical toxicologists. However, new poisons and poison<strong>in</strong>gs do catch us off-guarded from time to time. New poison<strong>in</strong>gshappen typically due to two causes: (1) New poison; (2) new unexpected human behaviour.New substances were usually <strong>in</strong>vented for <strong>in</strong>dustrial use, as new drugs or to be abused. They are easy to tackle. On the otherhand, predict<strong>in</strong>g human behaviour can be hopeless. For example, the explosion of ketam<strong>in</strong>e abuse after 2005 while the drughas been manufactured s<strong>in</strong>ce 1965. Another example was add<strong>in</strong>g tasteless and zero nutritional value substance melam<strong>in</strong>e<strong>in</strong>to milk products <strong>in</strong> 2008.The Toxico<strong>in</strong>telligence team is formed to tackle new poison<strong>in</strong>gs and to prepare for new outbreaks. We believe that thereare always h<strong>in</strong>ts or signals before every outbreak, only tra<strong>in</strong>ed eyes are needed to spot them. We believe that no outbreakis really unexpected though we acknowledge that at times their occurrence is unpreventable. That makes preparedness soimportant <strong>in</strong> poison control. Prevention and preparedness are our primary objectives.Thursday, 16 MayThe team is made up of members from the three pillar units of the Hospital Authority (HA) Toxicology Service, namely theHong Kong Poison Information Centre, the HA Toxicology Reference Laboratory, Pr<strong>in</strong>ce of Wales Hospital Poison TreatmentCentre together with pharmacists from the Chief Pharmacy Office, emergency physicians, physicians, chemical pathologists,pharmacists and scientists. The team cont<strong>in</strong>uously captures, monitors and evaluates <strong>in</strong>formation of possible new poison<strong>in</strong>gsfrom various available sources worldwide. New methodology is developed for scientific evaluation. Regular team meet<strong>in</strong>gsare hold for <strong>in</strong>-depth assessment of threats. Recommendations on prevention and management of such outbreaks aredrafted. Monographs are developed for new poison<strong>in</strong>g threats every year. They are communicated to relevant members anddepartments <strong>in</strong> the HA, the Department of Health as well as other concerned government agencies. Through the work of thisdedicated team, we hope to turn <strong>in</strong>formation <strong>in</strong>to <strong>in</strong>telligence that can at best prevent or at least well prepare Hong Kongaga<strong>in</strong>st new poison<strong>in</strong>g outbreaks <strong>in</strong> future.MC4.4 Toxicology Services 14:30 Theatre 1The Hong Kong Poison Control Network and the Role of Department of HealthAu AKWCentre for Health Protection, Department of Health, Hong Kong Special Adm<strong>in</strong>istrative Region GovernmentPoison<strong>in</strong>g is an important public health issue as it causes significant morbidity and mortality. Because of globalisation,poison<strong>in</strong>g outbreaks <strong>in</strong> one place may have potential impact <strong>in</strong> other places. Public health threats due to poison<strong>in</strong>g <strong>in</strong>cidentsare emerg<strong>in</strong>g and may affect the whole population.In the past few years, the Government has taken <strong>in</strong>itiatives to strengthen both the hardware and software <strong>in</strong> prevention andcontrol of poison<strong>in</strong>g us<strong>in</strong>g a multi-pronged approach. The Hong Kong Poison Control Network (HKPCN) was established <strong>in</strong>2007, aim<strong>in</strong>g to enhance the <strong>in</strong>frastructure and coord<strong>in</strong>ation among key players who take part <strong>in</strong> poison <strong>in</strong>formation service,cl<strong>in</strong>ical service, laboratory analytical service, toxicovigilance, professional tra<strong>in</strong><strong>in</strong>g and research.The HKPCN comprises units of the Hospital Authority (HA), the Department of Health (DH), relevant government departmentsand other stakeholders. Its four key components <strong>in</strong>clude DH and three units under the HA, namely the Hong Kong PoisonInformation Centre (HKPIC), the Poison Treatment Centre (PTC) and the Toxicology Reference Laboratory (TRL). HKPICprovides timely poison <strong>in</strong>formation and advice on cl<strong>in</strong>ical management of poison<strong>in</strong>g cases to healthcare professionals. PTCprovides tertiary level laboratory service on analytical toxicology. PTC provides tertiary treatment service for poison<strong>in</strong>gpatients.Poison<strong>in</strong>g cases of public health significance are reported to DH. These generally <strong>in</strong>volve Ch<strong>in</strong>ese herbal medic<strong>in</strong>es, westerndrugs, health products and slimm<strong>in</strong>g products adulterated with western drugs, heavy metal poison<strong>in</strong>g, etc. DH concernspublic health protection, <strong>in</strong>clud<strong>in</strong>g epidemiological <strong>in</strong>vestigation of reported cases and poison<strong>in</strong>g outbreaks; implementationof control measures to reduce exposure; risk communication and surveillance. Effective management of poison<strong>in</strong>g <strong>in</strong>cidentsrequires coord<strong>in</strong>ated efforts of the HA, DH, other government departments, academia and the media.For prevention, DH will cont<strong>in</strong>ue to regulate Ch<strong>in</strong>ese medic<strong>in</strong>es, proprietary Ch<strong>in</strong>ese medic<strong>in</strong>es and western medic<strong>in</strong>esthrough enforcement of related legislations, such as the Ch<strong>in</strong>ese Medic<strong>in</strong>e Ord<strong>in</strong>ance, Pharmacy and Poisons Ord<strong>in</strong>ance,Dangerous Drugs Ord<strong>in</strong>ance, etc. It will strengthen publicity and education to raise public awareness, and ma<strong>in</strong>ta<strong>in</strong> closecommunication with counterparts <strong>in</strong> areas outside Hong Kong especially the ma<strong>in</strong>land Ch<strong>in</strong>a.
Special TopicsST3.1 New Models of Healthcare Delivery System 09:00 Theatre 2Shared Decision Mak<strong>in</strong>g – Why Patients’ Preferences MatterMulley AGDartmouth Center for Health Care Delivery Science, Dartmouth College, USAResearch at Dartmouth and <strong>in</strong> other countries has shown wide variations <strong>in</strong> delivery rates of specific services and outcomesachieved. Health outcomes <strong>in</strong> high-rate, high-cost regions are not always better and can be worse. Variation is often theconsequence of a mismatch between system capacity to deliver different services, and the needs and wants of peopleserved. This mismatch distorts care, result<strong>in</strong>g <strong>in</strong> waste and harm that consumes 20% to 40% of health resources acrossnations.Much of the waste and harm is <strong>in</strong> deliver<strong>in</strong>g the wrong care – care that patients would not choose if better <strong>in</strong>formed. Theright treatment for a patient depends on his or her goals when trade-offs among treatment outcomes have to be weighed.Patients’ preferences matter to an extent rarely recognised by either cl<strong>in</strong>icians or patients.In response, shared decision mak<strong>in</strong>g was <strong>in</strong>troduced and supported by development of decision aids. Randomised trials<strong>in</strong> North Americas and Europe showed that patients had improved knowledge, more realistic expectations, greater trust <strong>in</strong>cl<strong>in</strong>icians, and reduced utilisation of many surgical <strong>in</strong>terventions <strong>in</strong>clud<strong>in</strong>g coronary surgery and stent<strong>in</strong>g, back surgery, jo<strong>in</strong>tsurgery, and other treatments.137HOSPITAL AUTHORITY CONVENTION 2013It has been estimated that engag<strong>in</strong>g people <strong>in</strong> decisions about the design and implementation of their healthcare couldlower health expenditures by roughly 20% while improv<strong>in</strong>g health outcomes. Preferences measured or revealed throughengagement can guide <strong>in</strong>vestments <strong>in</strong> healthcare capacity to achieve long-term efficiencies.The benefits of shared decision mak<strong>in</strong>g and patient engagement will be achieved only with strong leadership able to applydelivery science <strong>in</strong>clud<strong>in</strong>g measurement of and responsiveness to patients’ preferences. Dartmouth has organised the “HighValue Healthcare Collaborative” to support better decisions and achieve better outcomes <strong>in</strong> the United States and it forms acoalition of delivery science collaboratives <strong>in</strong> other countries <strong>in</strong>clud<strong>in</strong>g the United K<strong>in</strong>gdom and Ch<strong>in</strong>a.ST3.2 New Models of Healthcare Delivery System 09:00 Theatre 2Thursday, 16 MayPatients’ Rights and Professional DignityLau CInternational Advisory Group of Experts on Consumer Protection, United Nations Conference on Trade and Development,United Nations, Hong KongThe relationship between patient and medical professional raises a number of exceptional issues. The primary issue is thata patient is, <strong>in</strong> most circumstances, completely vulnerable to the expertise and discretion of the professional who is treat<strong>in</strong>gthe most important facet of a person’s needs, that is their personal health and well-be<strong>in</strong>g.The patient/professional relationship is generally considered as a k<strong>in</strong>d of partnership, based on mutual respect andcollaboration. Both doctor and patient have rights as well as responsibilities. Nevertheless, with changes <strong>in</strong> society,technology, science and law, new ethical and practical issues arised can challenge the way <strong>in</strong> which both parties view eachother, and <strong>in</strong>teract.Patients nowadays are <strong>in</strong>creas<strong>in</strong>gly consider<strong>in</strong>g themselves similar to consumers of other service providers that they choose<strong>in</strong> the market for particular services.An exam<strong>in</strong>ation of patients’ rights, with<strong>in</strong> the context of consumers, beg<strong>in</strong>s with the United Nations Guidel<strong>in</strong>es on ConsumerProtection. The guidel<strong>in</strong>es cover issues such as protection of health and safety aga<strong>in</strong>st hazards; promotion and protectionof economic <strong>in</strong>terests; access to adequate <strong>in</strong>formation; consumer education; availability of effective consumer redress; andfreedom to express their views <strong>in</strong> decision mak<strong>in</strong>g processes affect<strong>in</strong>g them.There is no direct conflict between patients’ rights and the respect for health professionals. As we develop healthcareservices <strong>in</strong> future, all parties <strong>in</strong>volved <strong>in</strong>clud<strong>in</strong>g patients, healthcare professionals, and government. They have to considerpatients as consumers, and acknowledge the needs to address their rights as consumers <strong>in</strong> the health sector, which will helpachieve our goals for an effective healthcare model that suits the needs of everyone.
138HOSPITAL AUTHORITY CONVENTION 2013Special TopicsST4.1 Medical Simulation 10:45 Theatre 2Innovation <strong>in</strong> Healthcare Education – Tra<strong>in</strong><strong>in</strong>g for Professional ExcellenceCurran IHealth of Innovation, London Deanery, National Health Service London, UKLearn<strong>in</strong>g ObjectivesIn this presentation, current challenges faced by the healthcare workforce will be shared. Current paradoxes and impactof confusions on healthcare education will also be highlighted. Through this critical analysis, the established educationalparadigms will be shared and potential opportunities will be identified for improv<strong>in</strong>g healthcare education.Draw<strong>in</strong>g upon experience as the Dean of Educational Excellence who leads London’s multi-award w<strong>in</strong>n<strong>in</strong>g Simulation andTechnology-enhanced Learn<strong>in</strong>g Initiative (STeLI), Dr Curran will <strong>in</strong>troduce strategic and operational concepts that collectivelyoffer a cogent educational philosophy. The underp<strong>in</strong>n<strong>in</strong>g concepts will be described and concepts such as educationalexcellence, disruptive <strong>in</strong>novation, simulation, technology-enhanced learn<strong>in</strong>g and effective educational leadership will behighlighted. It offers a unique opportunity for develop<strong>in</strong>g a high quality healthcare workforce.In this presentation, healthcare education will be set with<strong>in</strong> a wider context. In so do<strong>in</strong>g, the complex <strong>in</strong>terdependence ofeducation and service through a critical appraisal of phenomena such as organisational and professional culture, personaland professional identity and the fundamental importance of <strong>in</strong>dividual motivations and behaviours upon performance will beexplored. It aims to <strong>in</strong>form, provoke and encourage delegates to reappraise their current understand<strong>in</strong>g of what constituteshigh quality healthcare education.Thursday, 16 MayF<strong>in</strong>ally it is hoped that these novel <strong>in</strong>sights might suggest new directions, provide <strong>in</strong>novative educational opportunities andperhaps identify progressive and mean<strong>in</strong>gful milestones so stimulat<strong>in</strong>g a renaissance <strong>in</strong> healthcare education.ST4.2 Medical Simulation 10:45 Theatre 2Application of Simulators to Enhance the Tra<strong>in</strong><strong>in</strong>g of M<strong>in</strong>imal Access SurgeryTang CNDepartment of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong KongSurgical tra<strong>in</strong><strong>in</strong>g has undergone many changes <strong>in</strong> last two decades. Traditionally, tra<strong>in</strong><strong>in</strong>g <strong>in</strong> surgery has been based upon anapprenticeship model, with junior surgeons learn<strong>in</strong>g skills under the supervision of experienced surgeons <strong>in</strong> cl<strong>in</strong>ical sett<strong>in</strong>g.With the <strong>in</strong>creas<strong>in</strong>g number of new procedures, shorten<strong>in</strong>g of work<strong>in</strong>g hours and <strong>in</strong>creas<strong>in</strong>g expectation from the communityto the healthcare professionals, this traditional apprenticeship model is not enough. The grow<strong>in</strong>g awareness of the need forpatient safety and quality improvement has brought simulation-based tra<strong>in</strong><strong>in</strong>g to the forefront.Human and system errors are recognised causes of significant morbidity and mortality of different procedures. Technicalskills encompass the medical and procedural knowledge required for patient care, while non-technical skills are behaviourbasedand <strong>in</strong>clude task management, situation awareness, teamwork, decision-mak<strong>in</strong>g, and leadership. Both sets ofskills are required to improve patient safety and procedure quality. Simulation-based tra<strong>in</strong><strong>in</strong>g can provide an opportunityto practice technical and non-technical skills <strong>in</strong> a patient-safe environment. Several techniques of simulation are available<strong>in</strong>clud<strong>in</strong>g artificial tissues, animal models and virtual reality computer simulation. Simulation offers the opportunity forrehearsal of various different skills <strong>in</strong> a controlled, risk-free environment, allow<strong>in</strong>g for the development of mastery at a paceappropriate to the learner and offers a means for objective verification of skills.In conclusion, the use of simulation-based tra<strong>in</strong><strong>in</strong>g has important educational and societal advantages, and it is also avaluable tool to improve patient safety.
Corporate Scholarship PresentationsCS1.1 Cancer Services 13:15 Theatre 2Cancer Biology: Predictive Biomarkers for Tailored TherapiesKwan CKCl<strong>in</strong>ical Oncology Department, Queen Elizabeth Hospital, Hong KongObjective and Purpose(1) To study the advances <strong>in</strong> development and cl<strong>in</strong>ical applications of predictive biomarkers <strong>in</strong> personalised cancer treatment;and (2) to <strong>in</strong>corporate such knowledge <strong>in</strong>to cl<strong>in</strong>ical practice and research activities <strong>in</strong> the Hospital Authority (HA) <strong>in</strong> order toimprove cost effectiveness of management of cancer patients.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesPractice at the Institute of Cancer Research for four months with focus on active translational research and cancer biologyresearch programmes.Outcome and Experience Shar<strong>in</strong>gA predictive biomarker is used to predict response to treatment. By us<strong>in</strong>g this method, a level of personalisation is <strong>in</strong>troducedto the treatment regimen. Successful development of a biomarker is usually a long and uneasy process. Some predictivebiomarkers have already been <strong>in</strong>troduced <strong>in</strong> daily practice whereas others are still <strong>in</strong> different stages of development. Keyfeatures of different stages of biomarker development and difficulties encountered dur<strong>in</strong>g the process will be described.Moreover, the role of the HA <strong>in</strong> biomarker development will be briefly discussed.139HOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 May
140HOSPITAL AUTHORITY CONVENTION 2013Corporate Scholarship PresentationsCS1.2 Cancer Services 13:15 Theatre 2Cross-Clusters Collaborative <strong>Programme</strong> to Better Oncology Care Delivery ModelMak SSSDepartment of Cl<strong>in</strong>ical Oncology, Pr<strong>in</strong>ce of Wales Hospital, Hong KongObjective and Purpose of Overseas Tra<strong>in</strong><strong>in</strong>g18 delegates from six Oncology Centres completed the overseas tra<strong>in</strong><strong>in</strong>g programme from 2010 to 2012. The tra<strong>in</strong><strong>in</strong>g aims toimprove advanced cl<strong>in</strong>ical competency of nurses, explore current healthcare sett<strong>in</strong>g <strong>in</strong> overseas and broaden nurses’ horizon<strong>in</strong> healthcare service delivery.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesDelegates attended a four week cl<strong>in</strong>ical attachment <strong>in</strong> various sett<strong>in</strong>gs to ga<strong>in</strong> <strong>in</strong>sight for the development of nurse-led cl<strong>in</strong>ic;service enhancement <strong>in</strong> chemotherapy cl<strong>in</strong>ic; promotion of palliative care services; improvement of cl<strong>in</strong>ical sett<strong>in</strong>gs <strong>in</strong> wardand strengthen<strong>in</strong>g radiotherapy services, etc.Outcome and Experience Shar<strong>in</strong>gAfter the tra<strong>in</strong><strong>in</strong>g, delegates formed a Work<strong>in</strong>g Group to review the <strong>in</strong>formation gathered and experience ga<strong>in</strong>ed <strong>in</strong> theoverseas tra<strong>in</strong><strong>in</strong>g programme, <strong>in</strong> order to study the possibility to put <strong>in</strong> practice <strong>in</strong> Hong Kong and ultimately to establish anoncology care delivery model <strong>in</strong> Hong Kong. So far, the follow<strong>in</strong>g action plans for patients at risk of febrile neutropenia (FN)and undergo<strong>in</strong>g chemotherapy treatment were promoted to two focus groups.Thursday, 16 MayAction Plan 1: Streaml<strong>in</strong>ed care for patients at risk of febrile neutropeniaThe Work<strong>in</strong>g Group has started an audit to retrospectively review the admitted FN patients s<strong>in</strong>ce November 2012. At theend of January 2013, 60 patients were admitted due to FN with<strong>in</strong> four weeks of chemotherapy. 50% of them were admittedthrough Accident and Emergency Department (AED). The mean door-to-needle time was 262.8 m<strong>in</strong>utes. 3.3% of them hadserious medical complication and 3.3% died before fever resolution.FN is a potentially life threaten<strong>in</strong>g side effect of chemotherapy treatment. Nowadays, there is no consistent guidel<strong>in</strong>e/policyfor manag<strong>in</strong>g FN amongst chemotherapy providers and AED. As such, it is imperative to streaml<strong>in</strong>e the pathway of care forpatients with chemotherapy <strong>in</strong>duced FN through strategic plann<strong>in</strong>g and collaboration with other parties, e.g. liais<strong>in</strong>g with AEDfor driven triage workflow; patient education and staff tra<strong>in</strong><strong>in</strong>g on management of FN; and system improvement for cl<strong>in</strong>icalmanagement of FN.Action Plan 2: Proactive pre/under-treatment support for chemotherapy patientsThe growth of new chemotherapy cases over the years is tremendous. However, there is lack of systematic proactiveapproach to risk assessment and symptom management to manage or elim<strong>in</strong>ate chemotherapy-related symptoms beforeand dur<strong>in</strong>g treatment. The Work<strong>in</strong>g Group has started to promote this proactive approach through the establishment of apre-chemotherapy symptom risk assessment model, customised patient education, standardised symptom managementplan, and early detection and <strong>in</strong>tervention by review<strong>in</strong>g patients <strong>in</strong> accordance with the protocol.
Corporate Scholarship PresentationsCS1.3 Cancer Services 13:15 Theatre 2Overseas Corporate Scholarship <strong>Programme</strong> (OCSP) for Physiotherapist <strong>in</strong> Musculoskeletal Specialty <strong>in</strong> 2011Wong JMSPhysiotherapy Department, Alice Ho Miu L<strong>in</strong>g Nethersole Hospital, Hong KongObjectives of the Overseas Tra<strong>in</strong><strong>in</strong>g(1) To attend the chronic pa<strong>in</strong> management programme at the Royal North Shore Hospital; (2) to explore the feasibility ofadopt<strong>in</strong>g new chronic pa<strong>in</strong> management model <strong>in</strong> the Hospital Authority (HA); and (3) to enhance the role of physiotherapy <strong>in</strong>the area of chronic pa<strong>in</strong> management.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesAn overseas attachment programme was arranged for four local physiotherapists at the Pa<strong>in</strong> Management ResearchInstitute of Royal North Shore Hospital of the University of Sydney from 14 to 23 November 2011. ADAPT, the ma<strong>in</strong> theme ofthe programme, was a three-week <strong>in</strong>tensive cognitive behavioural pa<strong>in</strong> management programme for chronic pa<strong>in</strong> patients.ADAPT is conducted by a multi-discipl<strong>in</strong>ary team <strong>in</strong>clud<strong>in</strong>g cl<strong>in</strong>ical psychologists, physiotherapists, nurses, medicalspecialists and anaesthetists, who have extensive experience and tra<strong>in</strong><strong>in</strong>g <strong>in</strong> pa<strong>in</strong> management. The eight-day visit <strong>in</strong>cludedan attachment to a patient education class, self management programme, pa<strong>in</strong> cop<strong>in</strong>g strategy workshop, medicationwithdrawal cl<strong>in</strong>ic, sleep management, functional goal-sett<strong>in</strong>g sem<strong>in</strong>ar, research meet<strong>in</strong>g and cognitive therapy that arespecifically designed for chronic pa<strong>in</strong> management.141HOSPITAL AUTHORITY CONVENTION 2013Learn<strong>in</strong>g Po<strong>in</strong>tsThe programme sets as a reference and model for chronic pa<strong>in</strong> management. It <strong>in</strong>spires physiotherapists <strong>in</strong> Hong Kongabout the importance of timely screen<strong>in</strong>g, early <strong>in</strong>tervention and provision of evidence-based rehabilitation programme asthe prerequisite for success of chronic pa<strong>in</strong> management. Follow<strong>in</strong>g this overseas attachment programme, tra<strong>in</strong><strong>in</strong>g sessionswere conducted to 150 physiotherapist colleagues at different local hospitals so as to improve their knowledge, skill andcompetency on chronic pa<strong>in</strong> management. Pilot chronic pa<strong>in</strong> management educational class was launched at the Pr<strong>in</strong>ce ofWales Hospital <strong>in</strong> April 2012 to improve service quality. Three series of educational classes were also delivered. Relevantprogramme evaluation will be conducted <strong>in</strong> future.CS1.4 Cancer Services 13:15 Theatre 2Thursday, 16 MayProvision of Oncology Pharmacy Service at Pr<strong>in</strong>cess Margaret HospitalYip EYTPharmacy Department, Pr<strong>in</strong>cess Margaret Hospital, Hong KongBackgroundIn recent years, there has been a cont<strong>in</strong>uous growth of cancer patients, as well as <strong>in</strong>creas<strong>in</strong>g complexity of chemotherapyand targeted therapy treatment. In order to develop future cl<strong>in</strong>ical pharmacy leaders <strong>in</strong> oncology and to enhance qualityand safety of oncology pharmacy service, two pharmacists from the Hospital Authority (HA) hospitals were selected by theOverseas Corporate Scholarship Panel <strong>in</strong> 2010 to attend a three-month cl<strong>in</strong>ical oncology attachment at the University ofIll<strong>in</strong>ois at Chicago (UIC) sponsored by the Overseas Corporate Scholarship <strong>Programme</strong>.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesDur<strong>in</strong>g the cl<strong>in</strong>ical attachment at the UIC, the selected scholars ga<strong>in</strong>ed a wide spectrum of exposure <strong>in</strong> overallpharmacotherapy management of cancer patients, <strong>in</strong>clud<strong>in</strong>g development of cl<strong>in</strong>ical protocols, screen<strong>in</strong>g of chemotherapyorders, compilation of anti-emetic regimen, patient counsel<strong>in</strong>g, medication reconciliation, etc. In addition, the tra<strong>in</strong><strong>in</strong>g alsoallowed the scholars to ga<strong>in</strong> <strong>in</strong>sights of cl<strong>in</strong>ical practice and contributions made by specialist oncology pharmacists <strong>in</strong> theUnited States.Outcome and Experience Shar<strong>in</strong>gIn the Oncology Pharmacy Cl<strong>in</strong>ic, patients would be counseled by pharmacists before start of their chemotherapy treatment.The Oncology Pharmacist Cl<strong>in</strong>ic also provides a comprehensive medication management service and the chemotherapyprescriptions are also screened at the oncology pharmacist cl<strong>in</strong>ic. When patients are admitted, the Oncology WardPharmacists would compile a medication history and screen for drug allergies and drug <strong>in</strong>teractions.The Pharmacist-Hercept<strong>in</strong>-Cl<strong>in</strong>ic is designed to look after breast cancer patients receiv<strong>in</strong>g hercept<strong>in</strong> therapy. Thepharmacists would assess this group of patients accord<strong>in</strong>g to a pre-set protocol. For patient who meets the criteria,pharmacists would endorse the treatment and the patient can cont<strong>in</strong>ue with the hercept<strong>in</strong>ttherapy.Over 85% of the patients recognised and rated the oncology pharmacy service positively through a five-question survey.They reflected that pharmacist at cl<strong>in</strong>ic was helpful. They would like to talk to pharmacist dur<strong>in</strong>g chemotherapy visits.They also agreed that pharmacists were able to give them a better understand<strong>in</strong>g of chemotherapy, the pre-medicationsprescribed and help them to cope with side effects.
142HOSPITAL AUTHORITY CONVENTION 2013Corporate Scholarship PresentationsCS2.1 Pa<strong>in</strong> and Chronic Disease Management 14:30 Theatre 2Post Tra<strong>in</strong><strong>in</strong>g Shar<strong>in</strong>g on Hands on Cl<strong>in</strong>ical Experience of Paediatric Anaesthesia <strong>in</strong> the Children’s Hospital atWestmead (CHW)Ng JDepartment of Anaesthesiology, Queen Mary Hospital, Hong KongObjectives and Purpose of the Overseas Tra<strong>in</strong><strong>in</strong>gThe Children’s Hospital at Westmead (CHW) is a teach<strong>in</strong>g hospital of the University of Sydney and a member of the SydneyChildren’s Hospitals Network. It is a quaternary referral centre with more than 14,500 operations performed every year.The objectives of overseas cl<strong>in</strong>ical experience <strong>in</strong>clude: (1) to enhance and consolidate the skills and knowledge <strong>in</strong> paediatricanaesthesia <strong>in</strong> a world class children’s hospital; and (2) to become a member of a paediatric anaesthetist team together withsurgeons and operat<strong>in</strong>g theatre nurses, provid<strong>in</strong>g safe surgery to sick neonates, <strong>in</strong>fants and children.Our department plans to further expand our paediatric anaesthesia team to cope with the grow<strong>in</strong>g number of sick neonatesand children, the <strong>in</strong>creas<strong>in</strong>g complexity of their surgeries and the <strong>in</strong>creas<strong>in</strong>g needs <strong>in</strong> anaesthesia, analgesia and proceduralsedation.Thursday, 16 MayKey Tra<strong>in</strong><strong>in</strong>g Activities(1) Conduct perioperative assessment and management of paediatric patient; (2) perform anaesthesia for elective andemergency surgery of paediatric patient <strong>in</strong> all aspects, <strong>in</strong>clud<strong>in</strong>g general, neuro, orthropaedic, cardiac, thoracic; ear,nose and throat; plastic, ophthalmic, burn, oncology, maxillofacial, radio imag<strong>in</strong>g, dental, liver transplantation and kidneytransplantation surgery. There is also a neonatal <strong>in</strong>tensive care unit and a paediatric <strong>in</strong>tensive care unit which provideperioperative support for children when required; (3) acute pa<strong>in</strong> round; and (4) cont<strong>in</strong>uous medical education which <strong>in</strong>cludesweekly lecture of different topics, journal club, tutorials of paediatric anaesthesia, morbidity and mortality presentation.Outcome and Experience Shar<strong>in</strong>gBe<strong>in</strong>g sub-specialised <strong>in</strong> paediatric anaesthesia to provide cl<strong>in</strong>ical services, tra<strong>in</strong><strong>in</strong>g and teach<strong>in</strong>g; and (2) work<strong>in</strong>g as an<strong>in</strong>dependent neonatal on-call personnel to cover emergency surgery of neonates and critically ill children.CS2.2 Pa<strong>in</strong> and Chronic Disease Management 14:30 Theatre 2Overseas Corporate Scholarship <strong>Programme</strong> 2011/12 at Children’s Hospital of Philadelphia (CHOP): PostTra<strong>in</strong><strong>in</strong>g Shar<strong>in</strong>gLee SY 1 , Tang SK 21Department of Paediatrics, Pr<strong>in</strong>ce of Wales Hospital,2Department of Paediatrics and Adolescent Medic<strong>in</strong>e, Pr<strong>in</strong>cess Margaret Hospital,Hong KongObjective and Purpose of the Overseas Tra<strong>in</strong><strong>in</strong>gThe four-week tra<strong>in</strong><strong>in</strong>g programme at the Paediatric Intensive Care Unit (PICU) of the Children’s Hospital of Philadelphia(CHOP) enables us to acquire new knowledge <strong>in</strong> patient care and technology on assess<strong>in</strong>g the severity and therapy <strong>in</strong>medical and surgical stream; to learn how to prepare critical pathways of different patients; to explore the extended roles ofnurses <strong>in</strong> critical nurs<strong>in</strong>g; and to understand tra<strong>in</strong><strong>in</strong>g modality for paediatric <strong>in</strong>tensive care nurs<strong>in</strong>g.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesWe learnt cl<strong>in</strong>ical assessment skills by us<strong>in</strong>g comprehensive flow sheet dur<strong>in</strong>g bedside attachment; and participated <strong>in</strong> dailymulti-discipl<strong>in</strong>ary ward round which <strong>in</strong>cluded parents and patient discharge manager to facilitate discharge. Besides, welearnt how the hospital-wide and unit-based “mock code” run, which was a k<strong>in</strong>d of multi-discipl<strong>in</strong>ary paediatric resuscitationsimulation tra<strong>in</strong><strong>in</strong>g. We also jo<strong>in</strong>ed the hospital transport team led by nurses to receive patients from referred hospitals, andwe attended different classes to understand the extended roles of nurses such as be<strong>in</strong>g <strong>in</strong>travenous l<strong>in</strong>e experts, paediatricdialysis specialists, simulation tra<strong>in</strong>ers and nurse educators. We were honoured to meet the director of advanced practicenurs<strong>in</strong>g who <strong>in</strong>troduced the nurse practitioner programme <strong>in</strong> US; the child life specialist who facilitates better cop<strong>in</strong>g ofhospitalisation of sick child and their family members; and the family consultant who is ex-patient’s mother and a full timestaff of the hospital to provide <strong>in</strong>put on behalf of parents to promote “family centred care”.Outcome and Experience Shar<strong>in</strong>gWe highly value the philosophy of care at CHOP that it emphasises the partnership with parents and family members <strong>in</strong>care of their children. After tra<strong>in</strong><strong>in</strong>g, we share our overseas learn<strong>in</strong>g experience with our colleagues and medical team. Weencourage staff to communicate with families through a structured communication flow sheet. Not only are there designatedareas for families <strong>in</strong> hospital, but there should have special persons like “family consultants” to help <strong>in</strong> policy mak<strong>in</strong>g and unitdesign to address family needs.For patient assessment, we <strong>in</strong>troduce the use of Paediatric Early Warn<strong>in</strong>g Score (PEWS). In future, we target to use astandardised assessment form <strong>in</strong> our Centre of Excellence <strong>in</strong> Paediatrics and other paediatric units. We hope to havepositions similar to <strong>in</strong>dependent nurse-led transport teams or <strong>in</strong>travenous l<strong>in</strong>e experts. In addition, we have to enhance ourlearn<strong>in</strong>g passion through different learn<strong>in</strong>g modes.
Corporate Scholarship PresentationsCS2.3 Pa<strong>in</strong> and Chronic Disease Management 14:30 Theatre 2Overseas Corporate Scholarship <strong>Programme</strong> for Allied Health Professionals 2011 — Attachment <strong>Programme</strong> forAllied Health Professionals <strong>in</strong> Primary and Community Care of Patients Suffer<strong>in</strong>g from Chronic Lung DiseasesChu AWYOccupational Therapy Department, Pr<strong>in</strong>cess Margaret Hospital, Hong KongObjectives of the Overseas Tra<strong>in</strong><strong>in</strong>gTo provide overseas learn<strong>in</strong>g opportunity for allied health professionals through the “Liv<strong>in</strong>g Well with Chronic ObstructivePulmonary Disease (COPD) <strong>Programme</strong>” (LWWCOPDTM ) held at the Montreal Chest Institute of Canada, which aims toimprove service for patients with chronic lung disease <strong>in</strong> the Hospital Authority.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesThree occupational therapists and three physiotherapists jo<strong>in</strong>ed the two-week cl<strong>in</strong>ical attachment of the “Liv<strong>in</strong>g Well withCOPD <strong>Programme</strong>” at the Montreal Chest Institute of Canada from 3 to 14 October 2011. They learned from the strongmulti-discipl<strong>in</strong>ary team to adopt a uniform approach <strong>in</strong> self-management education and conduct an exercise programme tofacilitate patients’ self-health behaviours <strong>in</strong> both pharmacological and non-pharmacological aspects.143HOSPITAL AUTHORITY CONVENTION 2013Learn<strong>in</strong>g po<strong>in</strong>tsThe representatives learned that when self-health behaviours are performed on daily basis with success, COPD patientswill develop an improved sense of self-efficacy result<strong>in</strong>g <strong>in</strong> lifestyle changes which improves health status and m<strong>in</strong>imiseshealthcare utilisation <strong>in</strong> the long run. The programme implementation is further re<strong>in</strong>forced by case management approach.Case managers with effective cl<strong>in</strong>ical and psychosocial skills can support patients <strong>in</strong> build<strong>in</strong>g self-efficacy and therebybr<strong>in</strong>g about behavioural changes. In Hong Kong, high prevalence of COPD and the tendency of repeated exacerbations willcont<strong>in</strong>ue to put pressure on our healthcare system. Thus there is a need to <strong>in</strong>troduce changes <strong>in</strong> delivery of care for thispatient group whereas the LWWCOPDTM ga<strong>in</strong>s empirical support to be a solution. However, effective implementation ofprogramme def<strong>in</strong>itely needs the <strong>in</strong>volvement of other stakeholders <strong>in</strong>clud<strong>in</strong>g doctors, nurses and patients. Infrastructurechanges <strong>in</strong> our healthcare system are crucial to br<strong>in</strong>g ultimate success.Thursday, 16 May
144HOSPITAL AUTHORITY CONVENTION 2013Corporate Scholarship PresentationsCS2.4 Pa<strong>in</strong> and Chronic Disease Management 14:30 Theatre 2Overseas Paediatric Cl<strong>in</strong>ical Pharmacy Tra<strong>in</strong><strong>in</strong>g and Setup of Paediatric Satellite Pharmacy <strong>in</strong> Pr<strong>in</strong>cess MargaretHospitalYao R 1 , Lau C 1 , Shek CC 2 , Lee SY 2 , Chiu H 1 , Lee M 2 , Liu HL 2 , Ho E 21Department of Pharmacy, 2 Department of Paediatric and Adolescent Medic<strong>in</strong>e, Pr<strong>in</strong>cess Margaret Hospital, Hong KongObjectives and Purpose of the Overseas Corporate Scholarship <strong>Programme</strong>The Overseas Corporate Scholarship <strong>Programme</strong> for Pharmacists aims to develop future cl<strong>in</strong>ical pharmacy leaders <strong>in</strong>various specialised areas through provision of sponsorship to high potential pharmacists <strong>in</strong> undertak<strong>in</strong>g cl<strong>in</strong>ical attachment<strong>in</strong> advanced practice sites overseas. In 2011, two pharmacists were selected by the Overseas Corporate Scholarship Panelto attend a three-month attachment <strong>in</strong> paediatric specialty at the University of Ill<strong>in</strong>ois at Chicago (UIC) Medical Centre. Theattachment developed their <strong>in</strong>novative practice and expanded their practice opportunities to enhance pharmacotherapymanagement and safety for paediatric patients.Key Tra<strong>in</strong><strong>in</strong>g ActivitiesThe three-month tra<strong>in</strong><strong>in</strong>g and attachment programme was held by cl<strong>in</strong>ical pharmacy specialists from the Paediatric Cl<strong>in</strong>icalPharmacy of Neonatal Intensive Care Unit (NICU), Paediatric Intensive Care Unit and general paediatrics from the UIC fromFebruary 2011 to April 2011. Cl<strong>in</strong>ical services tra<strong>in</strong><strong>in</strong>g <strong>in</strong>cluded patient assessment on pharmacotherapy, drug therapyrecommendation and monitor<strong>in</strong>g, patient medication history <strong>in</strong>terviews and education, pharmacok<strong>in</strong>etic dos<strong>in</strong>g, parenteralnutrition consultations and specific drug <strong>in</strong>formation.Thursday, 16 MayOutcome and Experience Shar<strong>in</strong>gAfter tra<strong>in</strong><strong>in</strong>g, the Paediatric Satellite Pharmacy was set up at Pr<strong>in</strong>cess Margaret Hospital <strong>in</strong> June 2011 to provide cl<strong>in</strong>icalpharmacy service, complete parenteral nutrition review, pharmacok<strong>in</strong>etic monitor<strong>in</strong>g, drug dispens<strong>in</strong>g and PharmacyIntravenous Admixture Service (PIVAS) for NICU and Special Care Baby Unit (SCBU) patients.Over the 18-month period after the open<strong>in</strong>g of the Paediatric Satellite Pharmacy, medications for 18,305 patient days werereviewed, 22,008 medication orders were screened and 166 pieces of drug <strong>in</strong>formation was provided to doctors and nurses.28 “near miss” per 1,000 neonatal-activity-days were prevented compared with seven per 1,000 neonatal-activity-daysbefore setup of satellite pharmacy (p
Service Priorities and <strong>Programme</strong>s Free Papers145SPP5.1 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221Promot<strong>in</strong>g Evidence-based Practice <strong>in</strong> Prevent<strong>in</strong>g Methicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA)Bacteremia <strong>in</strong> Patients Hav<strong>in</strong>g Central Venous Catheter Undergo<strong>in</strong>g HaemodialysisHo HS, Kwan KLA, Chan SMV, Chow CCV, Wong CK, Mo KLS, Cho HY, Tsoi THDepartment of Medic<strong>in</strong>e, Pamela Youde Nethersole Eastern Hospital, Hong KongIntroductionMethicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA) is a nasty agent caus<strong>in</strong>g catheter-related bloodstream <strong>in</strong>fection (CR-BSI) <strong>in</strong> patients hav<strong>in</strong>g haemodialysis with central venous catheter (CVC). The <strong>in</strong>fection leads to hospitalisation, <strong>in</strong>creasedmorbidity and mortality which exert a f<strong>in</strong>ancial burden to the healthcare system.ObjectivesTo evaluate the effectiveness of implement<strong>in</strong>g evidence-based practice <strong>in</strong> prevent<strong>in</strong>g MRSA bacteremia <strong>in</strong> patients with CVCundergo<strong>in</strong>g haemodialysis.MethodologyFrom January 2012 to December 2012, bundled strategies were implemented to patients with end-stage renal disease (ESRD)who had CVC for haemodialysis. (1) Education and tra<strong>in</strong><strong>in</strong>g of healthcare personnel. (2) Patient and materials preparationfor catheter <strong>in</strong>sertion — a CVC cart conta<strong>in</strong><strong>in</strong>g all essential items, and a 2% chlorhexid<strong>in</strong>e wash for sk<strong>in</strong> cleans<strong>in</strong>g beforecatheter <strong>in</strong>sertion were prepared. (3) Apply<strong>in</strong>g maximal sterile barrier precautions dur<strong>in</strong>g CVC <strong>in</strong>sertion, and removal of not<strong>in</strong>-usecatheter immediately. (4) Us<strong>in</strong>g a 2% chlorhexid<strong>in</strong>e <strong>in</strong> 70% alcohol for sk<strong>in</strong> dis<strong>in</strong>fection, and us<strong>in</strong>g antiseptics to drybefore catheter <strong>in</strong>sertion. (5) Us<strong>in</strong>g povidone iod<strong>in</strong>e antiseptic o<strong>in</strong>tment at haemodialysis catheter exit site. (6) Emphasis<strong>in</strong>ghand hygiene, proper groom<strong>in</strong>g appearance and wear<strong>in</strong>g of mask.Besides bundled strategies, vigilant environmental cleans<strong>in</strong>g and removal of unnecessary items <strong>in</strong> cl<strong>in</strong>ical area wereessential for a successful programme. Exist<strong>in</strong>g guidel<strong>in</strong>es for perform<strong>in</strong>g haemodialysis were revised. Rout<strong>in</strong>e screen<strong>in</strong>g andmupiroc<strong>in</strong> decolonisation for Staphylococcus Aureus <strong>in</strong> the haemodialysis population was employed. Moreover, signage ofsk<strong>in</strong> preparation, maximal sterile barrier precautions were posted up <strong>in</strong> procedure room for easy reference. Patient educationon personal hygiene and home catheter care were stressed. Assessment on staff’s compliance to guidel<strong>in</strong>es was performedperiodically. Feedback of the cl<strong>in</strong>ical outcome to the staff was carried out regularly.ResultsFrom January 2012 to December 2012, there were 160 patients with ESRD hav<strong>in</strong>g CVC for haemodialysis. After implement<strong>in</strong>gthe bundled strategies, seven patients had MRSA bacteremia. The <strong>in</strong>fection rate dropped from 1.08 episodes/1,000 catheterdays to 0.5 episodes/1,000 catheter days. The MRSA bacteremia was significantly reduced by 46% compar<strong>in</strong>g with 2011. Nocase was reported for consecutive four months.HOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MayConclusionsBundled strategies have reduced the rate of CR-BSI. To susta<strong>in</strong> the desirable outcome cont<strong>in</strong>uous effort is required. Ongo<strong>in</strong>gsurveillance programme needs to be implemented to detect and prevent the spread of MRSA bacteremia.
146Service Priorities and <strong>Programme</strong>s Free PapersHOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MaySPP5.2 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221STAR Project: Strategic Targets Aim to Reduce Haemodialysis Catheter-related Bloodstream InfectionHo LF, Li YS, Lee SH, Wong SWY, Tang CMK, Kong ILL, Chu KH, Fung KS, Tong MKLDivision of Nephrology, Department of Medic<strong>in</strong>e and Geriatrics, Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionCatheter-related blood stream <strong>in</strong>fection (CRBSI) has been associated with <strong>in</strong>creased morbidity, mortality and healthcarecosts <strong>in</strong> patients requir<strong>in</strong>g haemodialysis (HD), which contributed to 19% of overall CRBSIs <strong>in</strong> Pr<strong>in</strong>cess Margaret Hospital <strong>in</strong>2007. Methicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA) accounted for more than 90% of all CRBSIs. The Strategic TargetsAim to Reduce (STAR) project was developed with evidence-based strategies <strong>in</strong> local context.ObjectivesTo reduce CRBSI rate among haemodialysis patients.MethodologyFrom February 2008 to January 2012, 409 haemodialysis patients with newly <strong>in</strong>serted haemodialysis catheters were analysedand traced over four years. The STAR project with seven-E preventive <strong>in</strong>tervention strategies was implemented to combatCRBSIs. For evaluation, MRSA decolonisation success rate, CRBSI rate, hand hygiene and haemodialysis procedurecompliance were assessed. (1) Exercise early MRSA nasal screen<strong>in</strong>g and timely decolonisation; (2) establish care pathwaysto standardise practice, education and monitor<strong>in</strong>g; 3.ensure adherence to five components of implement<strong>in</strong>g HD catheterbundle; (4) employ 2% chlorhexid<strong>in</strong>e bath before and five days after HD catheter <strong>in</strong>sertion; (5) educate patients and familycaregivers on daily vascular care; (6) evaluate specific <strong>in</strong>fection control practice; and (7) enhance staff compliance to handhygiene and HD procedures.ResultsAmong the 409 patients with 49,503 catheter days (mean=121 days/patient), 51 patients (12.5%) had history of MRSA and59 patients (14.4%) were MRSA nasal carriers on first screen<strong>in</strong>g. Among the 59 patients, 38 patients (64.4%) completeddecolonisation while the rema<strong>in</strong><strong>in</strong>g 21 patients (35.6%) died or removed HD catheters. Among the 38 patients, n<strong>in</strong>e patientsdisplayed re-colonisation, while 29 patients had negative MRSA screen<strong>in</strong>g post-three and post-12 month follow-up giv<strong>in</strong>ga high MRSA decolonisation rates of 76%. MRSA CRBSI markedly decreased from seven (2007) to three (2011) by 57%,result<strong>in</strong>g <strong>in</strong> significant hospital cost-sav<strong>in</strong>g of HK$107,300. The yearly CRBSI dropped 45% from 1.03 (2007) to 0.56(2011) per1,000 catheter days even with substantial <strong>in</strong>crease <strong>in</strong> catheter days by 85% (7,745 <strong>in</strong> 2007 to 14,374 <strong>in</strong> 2011). Periodic <strong>in</strong>ternalaudit showed that compliance to hand hygiene and catheter-related procedures were 96% and 100% respectively.ConclusionsA well-structured preventive <strong>in</strong>tervention programme can substantially lower CRBSI rates, which implies a reduction <strong>in</strong>mortality, hospitalisation, costs, improved patient outcomes and strengthened culture of safety. Further improvements on HDcatheter reduction with timely access creation, and assign<strong>in</strong>g a vascular access coord<strong>in</strong>ator for early dialysis plan for renalpatients are recommended.
Service Priorities and <strong>Programme</strong>s Free PapersSPP5.3 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221Procedural Sedation for Flexible Bronchoscopy <strong>in</strong> Grantham HospitalFung SL, Koo KF, Chan YH, Wong CFTuberculosis and Chest Unit,Grantham Hospital, Hong KongIntroductionMore than 500 patients undergo flexible bronchoscopy <strong>in</strong> Grantham Hospital (GH) each year. Optimal performance ofbronchoscopy means patient’s comfort, physician’s ease of execution, and m<strong>in</strong>imal risk. Conventional practice was doneby giv<strong>in</strong>g a s<strong>in</strong>gle dose of <strong>in</strong>tramuscular pethid<strong>in</strong>e (a narcotic) as premedication by nurs<strong>in</strong>g staff <strong>in</strong> ward and the patientwas transferred to the bronchoscopy suite by gurney. The protocol of procedural sedation for bronchosocpy <strong>in</strong> GH wasdeveloped <strong>in</strong> April 2012 after publication of the American College of Chest Physicians consensus statement on the use oftopical anaesthesia, analgesia, and sedation dur<strong>in</strong>g flexible bronchoscopy <strong>in</strong> adult patients. The primary objective of thechange <strong>in</strong> practice is to enhance patient tolerance and satisfaction without compromis<strong>in</strong>g safety.Objectives(1) To enhance patient tolerance and satisfaction; (2) to enhance patient safety; (3) to streaml<strong>in</strong>e logistics; and (4) to savemanpower.147HOSPITAL AUTHORITY CONVENTION 2013Methodology(1) The protocol of procedural sedation for bronchosocpy <strong>in</strong> GH was developed <strong>in</strong> late 2011 and fully implemented from June2012; (2) a questionnaire survey was conducted on 80 patients undergo<strong>in</strong>g bronchoscopy under procedural sedation and 81patients with the procedure done after conventional premedication.Results(1) More patients <strong>in</strong> the procedural sedation group were satisfied with the procedure (79% vs 42%). More patients <strong>in</strong> theprocedural sedation group were will<strong>in</strong>g to have the procedure repeated if needed (71% vs 33%). (2) As procedural sedationwas adm<strong>in</strong>istered <strong>in</strong> the bronchoscopy suite by the bronchoscopist, any adverse effect due to the medication could berecognised and handled <strong>in</strong> a timely manner. The dose titration approach ensured the optimal dose of sedation and analgesiawas given to a patient and avoided the unfavourable scenario of under/over sedation. (3) The patient transfer time from wardto bronchoscopy suite was reduced as patient, not under the effect of any sedative medication, was fully ambulatory beforeprocedure. Transfer by gurney was no longer necessary. (4) The accompany<strong>in</strong>g staff number was reduced from two to one.Thursday, 16 May
148HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP5.4 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221Paediatric Satellite Pharmacy <strong>in</strong> Pr<strong>in</strong>cess Margaret HospitalYao R 1 , Lau C 1 , Shek CC 2 , Lee SY 2 , Chiu H 1 , Lee M 2 , Liu HL 2 , Ho E 21Department of Pharmacy, 2 Department of Paediatric and Adolescent Medic<strong>in</strong>e,Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionMedication error is a common cause of iatrogenic morbidity and mortality <strong>in</strong> the Neonatal Intensive Care Unit (NICU) andSpecial Care Baby Unit (SCBU). Paediatric Satellite Pharmacy was set up at Pr<strong>in</strong>cess Margaret Hospital <strong>in</strong> June 2011accord<strong>in</strong>g to a preset service protocol to provide cl<strong>in</strong>ical pharmacy service, total parenteral nutrition review, pharmacok<strong>in</strong>eticmonitor<strong>in</strong>g, drug dispens<strong>in</strong>g and Pharmacy Intravenous Admixture Service (PIVAS) for NICU and SCBU patients.ObjectivesThe Paediatric Satellite Pharmacy services aim to reduce medication errors and improve quality of patient care <strong>in</strong> NICU andSCBU.Thursday, 16 MayMethodologyAn <strong>in</strong>tervention study was conducted over an 18-month period between July 2011 and December 2012. All <strong>in</strong>terventionsby the cl<strong>in</strong>ical pharmacist to optimise prescription and cl<strong>in</strong>icians’ acceptance were recorded. Medication <strong>in</strong>cidents werecollected from the Advanced Incident Report System (AIRS) to compare the <strong>in</strong>cident rate dur<strong>in</strong>g operat<strong>in</strong>g and non-operat<strong>in</strong>ghours of Paediatric Satellite Pharmacy. A satisfaction survey to evaluate the service was completed by nurses and doctors <strong>in</strong>September 2012.ResultsOver the 18-month period, the cl<strong>in</strong>ical pharmacist reviewed medications for 18,305 patient days, screened 22,008 medicationorders and provided 166 pieces of drug <strong>in</strong>formation to doctors and nurses. 28 “near miss” per 1,000 neonatal-activity-dayswere prevented compared with seven per 1,000 neonatal-activity-days before setup of satellite pharmacy (p
Service Priorities and <strong>Programme</strong>s Free PapersSPP5.5 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221Effectiveness of Barcode Track<strong>in</strong>g <strong>in</strong> Document<strong>in</strong>g and Prevent<strong>in</strong>g Patient Specimen Identification Errors <strong>in</strong>Anatomical Pathology LaboratoryLee KC, Wong SN, Leung YW, Lung PC, Yau WN, Lam WLDepartment of Pathology, Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionPatient specimen identification errors have been reported as the lead<strong>in</strong>g cause of laboratory errors. Such errors may result<strong>in</strong> patient harm and are completely preventable. However, <strong>in</strong> the multi-step and mostly manual process<strong>in</strong>g environmentof anatomical pathology laboratory, difficulties <strong>in</strong> fully and reliably identify<strong>in</strong>g these errors may h<strong>in</strong>der the implementationof effective corrective measures. Such difficulties <strong>in</strong>clude lack of effective and timely <strong>in</strong>formation collection mechanism,variation <strong>in</strong> report<strong>in</strong>g practices, and stigma of disclos<strong>in</strong>g errors.ObjectivesAn <strong>in</strong>novative track<strong>in</strong>g system us<strong>in</strong>g 2D-barcode technology has been implemented <strong>in</strong> the anatomical pathology laboratoryto ensure correctness of tissue and cytology process<strong>in</strong>g. The aim is, through automatic track<strong>in</strong>g and captur<strong>in</strong>g manualprocess<strong>in</strong>g data <strong>in</strong> every step of specimen transfer, to study the <strong>in</strong>formation collected so as to assess the effectiveness ofsystem <strong>in</strong> prevent<strong>in</strong>g potential specimen identification <strong>in</strong>cidents.149HOSPITAL AUTHORITY CONVENTION 2013MethodologyUnique 2D-barcode identifiers were assigned and pr<strong>in</strong>ted on each specimen conta<strong>in</strong>er, tissue cassette, histology andcytology slides, and task slip for additional special studies. Us<strong>in</strong>g a novel “relational-coupl<strong>in</strong>g” approach, a track<strong>in</strong>g systemwas developed locally to capture relevant <strong>in</strong>formation, <strong>in</strong>clud<strong>in</strong>g operator, time, and location <strong>in</strong> every specimen transfer step.Identification mismatch errors were documented automatically for further analysis.ResultsIn the 12-month period from February 2012 to January 2013, a total of 35,934 laboratory requests were processed atPr<strong>in</strong>cess Margaret Hospital, <strong>in</strong>volv<strong>in</strong>g assign<strong>in</strong>g unique 2D barcode identifiers to 46,386 specimen conta<strong>in</strong>ers, 66,605 tissuecassettes, and 134,305 slides, of which 80,894 were for rout<strong>in</strong>e histology. Mismatch errors documented <strong>in</strong>cluded 177 (0.38%)<strong>in</strong> specimen sampl<strong>in</strong>g, 442 (0.66%) <strong>in</strong> section-pickup, and 310 (0.38%) <strong>in</strong> slide release to report<strong>in</strong>g. In addition, of the 25,973tasks for additional special studies, 265 (1.02%) errors were recorded. No identification <strong>in</strong>cident was resulted as all mismatcherrors were successfully signaled to the operator for immediate rectification. The barcode track<strong>in</strong>g system is therefore highlyeffective <strong>in</strong> ensur<strong>in</strong>g correct patient specimen identification. The automatic process-specific error report<strong>in</strong>g, with <strong>in</strong>formationhitherto unavailable by manual means, would be very useful for implement<strong>in</strong>g further targeted measures for cont<strong>in</strong>uousquality improvement.Thursday, 16 May
150HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP5.6 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221The Effect of Introduc<strong>in</strong>g Rout<strong>in</strong>e Use of Intracameral Cefuroxime on Post-operative Endophthalmitis <strong>in</strong>Cataract Surgery <strong>in</strong> a Ch<strong>in</strong>ese PopulationLi KK 1,2, 3 , Ng AL 1 , Tang WW 2, 3 , Li PS 1, 3 , Mak K 4 , Fung KS 51Department of Ophthalmology, United Christian Hospital, 2 Department of Ophthalmology, Tseung Kwan O Hospital,3Wu Ho Loo N<strong>in</strong>g Cataract Centre, Kowloon East Cluster, 4 Pharmacy, Kowloon East Cluster,5Department of Pathology, United Christian Hospital,Hong KongIntroductionCataract surgery is recognised as one of the safest surgical procedures. However, post-operative endophthalmitis, althoughuncommon, can have devastat<strong>in</strong>g effect on the f<strong>in</strong>al visual outcome. There is <strong>in</strong>creas<strong>in</strong>g evidence worldwide that the use of<strong>in</strong>tracameral cefuroxime can greatly reduce the risk of endophthalmitis.ObjectivesTo study the effect of <strong>in</strong>troduction of rout<strong>in</strong>e use of <strong>in</strong>tracameral cefuroxime on post-operative endophthalmitis <strong>in</strong> HospitalAuthority sett<strong>in</strong>g.Thursday, 16 MayMethodologyAll cases that underwent cataract surgeries over an eight-year period, from January 2004 to June 2012, at a tertiary eyecentre <strong>in</strong> Hong Kong were retrospectively reviewed. The rout<strong>in</strong>e use of <strong>in</strong>tracameral cefuroxime at the end of cataract surgerywas <strong>in</strong>troduced at our centre s<strong>in</strong>ce April 2010. All cases had pre-operative 5% povidone iod<strong>in</strong>e antisepsis with no preoperativeuse of prophylactic antibiotic agents. The rate of post-operative endophthalmitis before April 2010 (Group 1, no useof <strong>in</strong>tracameral cefuroxime) and after April 2010 (Group 2, rout<strong>in</strong>e use of <strong>in</strong>tracameral cefuroxime) was compared.ResultsA total of 16,045 eyes (7,332 <strong>in</strong> Group 1 and 8,713 <strong>in</strong> Group 2) were studied. Eight cases developed post-operativeendophthalmitis (1.09 <strong>in</strong> 1,000; 0.11%) <strong>in</strong> Group 1 whereas none developed endophthalmitis (0 %) <strong>in</strong> Group 2. The rate ofreduction were statistically significant (p=0.002, Fisher’s Exact test). Six out of eight cases of endophthalmitis were culturepositive. Organisms <strong>in</strong>cluded Group G streptococcus (two cases), Staphylococcus Aureus, Group B streptococcus, Serratiamarcescens, and coagulase negative staphylococcus. Four out of six organisms were sensitive to penicill<strong>in</strong> group. Noadverse events related to the use of <strong>in</strong>tracameral cefuroxime were encountered.ConclusionsThe rout<strong>in</strong>e use of <strong>in</strong>tracameral cefuroxime dur<strong>in</strong>g cataract operation significantly reduced the rate of post-operativeendophthalmitis <strong>in</strong> Ch<strong>in</strong>ese patients (p=0.002).
Service Priorities and <strong>Programme</strong>s Free Papers151SPP5.7 Quality and Safety <strong>in</strong> Healthcare II 09:00 Room 221Positive Outcome from Implementation of Patient Safety Round by Frontl<strong>in</strong>e Staff <strong>in</strong> Surgical DepartmentShe HFA, Fung SY, Ho WFDepartment of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong KongIntroductionIt is understandable that a patient’s perception of quality of healthcare ma<strong>in</strong>ly depends on the carer’s ability to meet thepatient’s needs. Regular ward round is believed to have positive impact on patient care. It is important to develop andimplement a nurs<strong>in</strong>g round protocol <strong>in</strong> Department of Surgery to promote patient safety and satisfaction <strong>in</strong> ward.Objectives(1) To develop and standardise a ward round protocol as a route of practice <strong>in</strong> the Surgical Department; (2) to enhance patientsafety <strong>in</strong> terms of fall rate; (3) to enhance quality of patient care as reflected by number of appreciation received from patientsor their relatives; and (4) to promote cl<strong>in</strong>ical learn<strong>in</strong>g and communications among colleagues.MethodologyBetween duty shifts, night shift (05:00), AM shift (09:00 and 14:00) or PM shift (22:00), tra<strong>in</strong>ed Healthcare Assistant/PatientCare Assistant will perform patient safety round at least once with respect to designed “patient safety round protocol” whichconta<strong>in</strong>s 11 items. They will then sign on the nurs<strong>in</strong>g prescription sheet after complet<strong>in</strong>g the safety round. Team nurse,shift <strong>in</strong>-charge and ward manager will cont<strong>in</strong>ue to monitor their compliance and ensure quality outcome. This ongo<strong>in</strong>gprogramme has been started s<strong>in</strong>ce October 2010 and all <strong>in</strong>patients with<strong>in</strong> four acute surgical wards have been <strong>in</strong>cluded <strong>in</strong>this programme. The parameters of outcome measurement are yearly fall rate and number of appreciation received.ResultsAs recorded, the yearly fall rate of these four surgical wards decreased by 21% <strong>in</strong> both 2011 and 2012, and number ofappreciation <strong>in</strong>creased by 29% <strong>in</strong> 2011 and 26% <strong>in</strong> 2012 when compared to 2010.ConclusionA regularly conducted protocol <strong>in</strong>corporat<strong>in</strong>g specific actions <strong>in</strong>to ward rounds can reduce the frequency of use of patientcall bell, <strong>in</strong>crease their satisfaction with healthcare, and reduce falls. Based on the results, the ward round protocol can servethe above purposes effectively.HOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 May
152Service Priorities and <strong>Programme</strong>s Free PapersHOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MaySPP6.1 Susta<strong>in</strong>able Workforce 10:45 Room 221Evidenced-based Approach to Promote Work Safe BehaviourChan CL 1 , Tang C 1 , Yip CH 1 , So P 2 , So E 3 , Wong SL 41Medic<strong>in</strong>e and Geriatric Department, Pr<strong>in</strong>cess Margaret Hospital, 2 Occupational Department, Kowloon West ClusterOccupational Medic<strong>in</strong>e, 3 Physiothery Department, Kowloon West Cluster Occupational Medic<strong>in</strong>e, 4 Central Nurs<strong>in</strong>g Division,Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionWork-related musculoskeletal disorders (WMSDs) are a group of pa<strong>in</strong>ful disorders of muscles, tendons and nerves whichassociate with frequent repetitive activities with awkward posture. Musculoskeletal disorder is a common occupationalproblem for healthcare workers that causes loss of productivity and reduction of staff morale, which affect the quality ofpatient care. Systematic literature review on previous studies and hospital <strong>in</strong>jury-on-duty (IOD) statistics found that it isnecessary to strengthen manual handl<strong>in</strong>g operation for staff safety. “Work Safe Behaviour” may help to promote safe manualhandl<strong>in</strong>g operation (MHO) culture and practice to reduce occupational unsafe behaviours and IODs.ObjectivesIntended improvement is based on two categories: (1) Promote staff’s wellness <strong>in</strong> Medic<strong>in</strong>e and Geriatrics (M&G)Department — to promote stretch<strong>in</strong>g exercises before perform<strong>in</strong>g MHO tasks; to help staff understand oneself’s andpatient’s capability to meet with the physical demand of daily work; to provide education talks and workshops on properMHO handl<strong>in</strong>g. (2) Provide a safe and healthy workplace to healthcare workers — to identify high risk MHO tasks by form<strong>in</strong>ga work<strong>in</strong>g and focus group; to evaluate the work process by an ergonomic checklist; to work out a tailor-made ergonomic<strong>in</strong>tervention programme which <strong>in</strong>cludes education and hands-on practice.Methodology(1) Set up a work<strong>in</strong>g group on Staff Wellness <strong>Programme</strong>, which composed of multi-discipl<strong>in</strong>es <strong>in</strong>clud<strong>in</strong>g nurse supervisors,occupational therapist, physiotherapist and occupational safety and health officer; (2) recruited 15 nom<strong>in</strong>ated MHO tra<strong>in</strong>the-tra<strong>in</strong>ers(MHOTTTs) to form a focus group; to formulate a checklist on tra<strong>in</strong><strong>in</strong>g assessment to ensure safe work process;to become tra<strong>in</strong>ers and assessors; to conduct onsite tra<strong>in</strong><strong>in</strong>gs to support<strong>in</strong>g staffs and re<strong>in</strong>forced practis<strong>in</strong>g of stretch<strong>in</strong>gexercises with work safe concept; (3) identified high-risk MHO tasks; (4) prepared a set of materials <strong>in</strong>clud<strong>in</strong>g satisfactionsurvey ,video, poster and questionnaires for knowledge assessment; and (5) evaluated the programme by quiz (questionnaires),skill assessment (checklist), satisfaction survey and statistics on IOD and sick leave rate.Results(1) The IOD and sick leave rate related to MHO of support<strong>in</strong>g and nurs<strong>in</strong>g staffs <strong>in</strong> M&G Department decreased; (2) bothquiz and skill assessment showed an overall noticeable improvement of score and performance at two weeks and 10weeks respectively after the programme (p
Service Priorities and <strong>Programme</strong>s Free PapersSPP6.2 Susta<strong>in</strong>able Workforce 10:45 Room 221Staff Competency <strong>Programme</strong> <strong>in</strong> Manual Handl<strong>in</strong>g Operation (MHO) ManagementChan Y, S<strong>in</strong> YCOccupational Safety and Health Team, Kowloon East Cluster Hong KongIntroductionManual handl<strong>in</strong>g operation (MHO) related <strong>in</strong>juries always rank the top three on <strong>in</strong>jury-on-duty (IOD) cases and contributed tolong sick leave (113 cases, 7,480 days lost <strong>in</strong> 2008/09).ObjectivesTo reduce IOD and sick leave; and (2) to enhance staff competency of MHO skill.MethodologyThe programme aimed at enhanc<strong>in</strong>g colleagues’ competency by: (1) form<strong>in</strong>g a work<strong>in</strong>g group with experts <strong>in</strong> ergonomicsand users to analyse causes of <strong>in</strong>juries; (2) deliver<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g with identified themes; (3) re<strong>in</strong>forc<strong>in</strong>g onsite supervision byus<strong>in</strong>g endorsed checklists; (4) provid<strong>in</strong>g post-<strong>in</strong>jury support <strong>in</strong> treatment, care and return-to-work, <strong>in</strong> collaboration withOccupational Medic<strong>in</strong>e Care Services; (5) organis<strong>in</strong>g promotions to arouse staff awareness; and (6) coord<strong>in</strong>at<strong>in</strong>g recognitionscheme for encourag<strong>in</strong>g improvement. The pre- and post-<strong>in</strong>cident data, coverage <strong>in</strong> tra<strong>in</strong><strong>in</strong>g, f<strong>in</strong>d<strong>in</strong>gs <strong>in</strong> occupational safetyand health (OSH) survey, and recognition ga<strong>in</strong>ed serve as outcome measures.153HOSPITAL AUTHORITY CONVENTION 2013ResultsOverall IOD per 100 staff decreased by 41% between January and December 2012 vs April 2008 to March 2009 respectively.MHO related IOD rate decreased by 57% whereas the days lost decreased by 12%. About 76% of nurs<strong>in</strong>g and support<strong>in</strong>gcolleagues (3,589) were covered <strong>in</strong> 42 sessions. Tra<strong>in</strong><strong>in</strong>g videos were produced for tra<strong>in</strong>ers who delivered tra<strong>in</strong><strong>in</strong>g atdepartments for the rema<strong>in</strong><strong>in</strong>g staff. In 2011/12, about 85% of new support<strong>in</strong>g and nurs<strong>in</strong>g staff (646) have completedtra<strong>in</strong><strong>in</strong>gs. A comprehensive OSH survey was conducted <strong>in</strong> December 2011, with 415 returns received. More than 63%showed “agree/strongly agree” to the overall effectiveness of exist<strong>in</strong>g OSH programmes, and <strong>in</strong> survey questions of “confidentto do job safely” and “felt satisfied with my job needs at work” respectively. Positive recognitions from <strong>in</strong>ternal and externalparties were ga<strong>in</strong>ed: (1) W<strong>in</strong>ner Award at Human Resources Development Category <strong>in</strong> Hospital Management Asia 2012;(2) 13 papers were accepted by the Hospital Authority (HA) Convention from 2008 to 2012; (3) as <strong>in</strong>vited guests to share atHA OSH Conference 2011, HA OSH Shar<strong>in</strong>g on Ergonomics Improvement <strong>Programme</strong> 2012 and Shar<strong>in</strong>g Sem<strong>in</strong>ar of CivilServices Bureau 2011; (4) Bronze Award of The Hong Kong OSH Award 2011 organised by Occupational Safety and HealthCouncil (OSHC); (5) six colleagues were honoured awards, <strong>in</strong>clud<strong>in</strong>g Gold, Silver, Bronze and Merit awards of The Best OSHEmployee organised by OSHC and Labour Department from 2009 to 2012.Thursday, 16 MayConclusionsWith improvement <strong>in</strong> MHO, our workforce can be ma<strong>in</strong>ta<strong>in</strong>ed at a high standard <strong>in</strong> terms of manpower availability, staffcommitment and happ<strong>in</strong>ess.
154Service Priorities and <strong>Programme</strong>s Free PapersHOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MaySPP6.3 Susta<strong>in</strong>able Workforce 10:45 Room 221Retention of Support<strong>in</strong>g Staff Start<strong>in</strong>g from Their Pre-employmentS<strong>in</strong> YC, Lau CH, Cheng KS, Yeung HH, Shiu YW, Chan MHDepartment of Human Resources, United Christian Hospital, Hong KongIntroductionThe turnover rate of support<strong>in</strong>g staff with<strong>in</strong> their six-month probation period from April 2010 to March 2011 was as high as88.4% <strong>in</strong> United Christian Hospital (UCH). It adversely affected the hospital operation <strong>in</strong> the follow<strong>in</strong>g ways: (1) Positionsleft vacant result<strong>in</strong>g <strong>in</strong> lack of manpower; (2) supervisors’ effort <strong>in</strong> tra<strong>in</strong><strong>in</strong>g new staff wasted; (3) staff morale worsened; (4)overall patient services affected. A six-month pilot scheme on retention of support<strong>in</strong>g staff with<strong>in</strong> their probation period wasimplemented <strong>in</strong> November 2011 <strong>in</strong> UCH.ObjectivesTo reduce the turnover rate of support<strong>in</strong>g staff with<strong>in</strong> their probation period.Methodology(1) Form a work<strong>in</strong>g group; (2) identify gap through review of exit <strong>in</strong>terviews and questionnaires; (3) validate the gaps identifiedthrough conduct<strong>in</strong>g <strong>in</strong>terview with department heads; (4) list clear job requirements <strong>in</strong> the Vacancy Notice Circular (VNC) andarrange ward/department visits for selected candidates before appo<strong>in</strong>tment to let candidates have thorough understand<strong>in</strong>gof work and its environment; (5) rem<strong>in</strong>d front-l<strong>in</strong>e supervisors to make good preparation, e.g. e-mail account, office spacearrangement, etc. and assign a mentor for the new staff before duty assumption; (6) assign designated human resources(HR) officer to take care of HR and non-HR matters of the new comers with welcome card and personal contact to be given;(7) organise mentorship programme for the mentors nom<strong>in</strong>ated by department heads and provide subsequent support; (8)arrange hospital chief executive (HCE) gather<strong>in</strong>g on top of hospital orientation programme so that new staff could exchangeviews with HCE dur<strong>in</strong>g the first quarter of their employment; and (9) collect feedback from new staff and department headsfor review.ResultsFollow<strong>in</strong>g the implementation of the pilot scheme, from November 2011 to May 2012, there was a significant drop <strong>in</strong> turnoverof the support<strong>in</strong>g staff with<strong>in</strong> their probation. The turnover rate for the said period was 37.1%, i.e. 22% decrease as comparedto the same period of the preced<strong>in</strong>g year. The retention programme was effective <strong>in</strong> reduc<strong>in</strong>g the turnover rate of support<strong>in</strong>gstaff dur<strong>in</strong>g their probation period. It was also <strong>in</strong> l<strong>in</strong>e with the “Vision Mission and Values” of the Hospital Authority as itsupported the vision of “happy staff”, echoed the values of “committed staff” and “teamwork”, and helped to deliver themission of “help<strong>in</strong>g people stay healthy” consequently. Further enhancement of the programme such as strengthen<strong>in</strong>g exit<strong>in</strong>terview mechanism and close liaison with front-l<strong>in</strong>e department heads on subsequent follow-up actions would be adopted.
Service Priorities and <strong>Programme</strong>s Free PapersSPP6.4 Susta<strong>in</strong>able Workforce 10:45 Room 221Advance Measures <strong>in</strong> Promot<strong>in</strong>g Radiation Safety for Operat<strong>in</strong>g TheatreLam LCC 1 , Cheung A 1 , Lam N 21Caritas Medical Centre, 2 Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionInformation from different sources revealed that there were <strong>in</strong>consistent safety measures among operat<strong>in</strong>g theatres (OT)before 2002. The <strong>in</strong>consistency may result <strong>in</strong> unnecessary exposure to ioniz<strong>in</strong>g radiation for the OT staff. Physicist’s visit hasbeen arranged to measure our environment <strong>in</strong> all dimensions for level of radiation leak. Result showed that the <strong>in</strong>stantaneousdose rate of a “mobile” C-arm exceeds the limit of 3uSv/hr outside the room with reference from the Radiation Ord<strong>in</strong>anceCAP 303 Regulation for “static” Irradiat<strong>in</strong>g Apparatus. Accord<strong>in</strong>g to the result, measurements were worked out andimprovement project was undertaken.ObjectivesTo identify possible risks <strong>in</strong> OT related to radiation safety throughout the activity to arouse staff’s concern <strong>in</strong> radiation safetyand ease their worries when they knew more.155HOSPITAL AUTHORITY CONVENTION 2013MethodologyArrange physicist’s visit to measure our environment <strong>in</strong> all dimensions for level of radiation leak, e.g. <strong>in</strong>side and outsidethe theatre to look for safe marg<strong>in</strong>. (1) C-arm screen<strong>in</strong>g <strong>in</strong> the theatre on an X-ray phantom which is similar to human bodyabsorb<strong>in</strong>g the radiation. Handheld Surveillance Dosimeter is used to detect radiation level <strong>in</strong> different distance <strong>in</strong>sidetheatre while screen<strong>in</strong>g. (2) Handheld surveillance dosimeter is also used to detect area outside theatre while screen<strong>in</strong>g isundertaken <strong>in</strong>side theatre, and check the safe marg<strong>in</strong> outside theatre.ResultsThe <strong>in</strong>stantaneous dose rate of a “mobile” C-arm exceeds the limit of 3uSv/hr outside the room with reference from theRadiation Ord<strong>in</strong>ance CAP 303 Regulation for “static” Irradiat<strong>in</strong>g Apparatus. The safest area shown was the area beh<strong>in</strong>d thelead shield 1.25uSv/hr. Advanced actions were worked out for the department: (1) The number of protective devices hasgreatly <strong>in</strong>creased based on the actual leak measured by physicist, and number of lead apron, neck collar and lead shield<strong>in</strong>creased to adequately support personnels of three theatres; (2) protective blankets were newly added for the protection ofpatient; (3) clear labels were made to identify the safety zone and warn<strong>in</strong>g sign shown that no observer should stand outsidethe theatre; (4) ease the concern of all staff <strong>in</strong>clud<strong>in</strong>g anaesthetists.Thursday, 16 MayConclusionsRadiation safety issue <strong>in</strong> our theatre has been greatly improved among staff. Local measurements have been modified toalert all personnel. Moreover, the result of the environment screen<strong>in</strong>g has been brought to the Hospital Authority Head Officefor further recommendation. Accord<strong>in</strong>g to the result of this activity, the safety issue <strong>in</strong> our new block was under concern andtwo theatres were approved to build with lead l<strong>in</strong><strong>in</strong>g wall.
156HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP6.5 Susta<strong>in</strong>able Workforce 10:45 Room 221Advanced Oncology Nurs<strong>in</strong>g Practice <strong>in</strong> Intravenous Bolus Injection of Cytotoxic Vesicants: Our 14-yearExperienceL<strong>in</strong>g WM, Au WY, Tsui TW, Chan MFMDepartment of Cl<strong>in</strong>ical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong KongIntroductionIntravenous (IV) <strong>in</strong>jection of cytotoxic vesicants has been developed as an advanced oncology nurs<strong>in</strong>g practice <strong>in</strong> ourdepartment s<strong>in</strong>ce 1998. Currently, it is also a key oncology nurs<strong>in</strong>g credential<strong>in</strong>g item <strong>in</strong> hospital accreditation. Vesicantextravasation can potentially lead to serious morbidity or even mortality <strong>in</strong> chemotherapy patients. Thus, it is a significant riskmanagement issue <strong>in</strong> oncology sett<strong>in</strong>g. A reliable and susta<strong>in</strong>able system is important to ensure patient safety and servicestandard <strong>in</strong> this area.Objectives(1) To provide a well-structured and formalised tra<strong>in</strong><strong>in</strong>g to designated chemotherapy nurses; (2) to ensure their competency<strong>in</strong> chemotherapy adm<strong>in</strong>istration, especially IV vesicant <strong>in</strong>jection; and (3) to monitor the service performance cont<strong>in</strong>uously andidentify areas for improvement proactively.Thursday, 16 MayMethodologyA formalised chemotherapy nurse <strong>in</strong>jector tra<strong>in</strong><strong>in</strong>g programme, which comprises four theory modules and supervised cl<strong>in</strong>icalpracticum, has been established s<strong>in</strong>ce 1998. Its contents are regularly updated to catch up with any new developments <strong>in</strong>the field. Upon the completion of tra<strong>in</strong><strong>in</strong>g, nurse tra<strong>in</strong>ees are required to go through a f<strong>in</strong>al assessment. Successful nurseswill receive a hospital certificate and be allowed to practise <strong>in</strong>dependently. Regular reassessment is needed to re-verify theircompetency. Any extravasation <strong>in</strong>cidents will be reported as required, and its trend is monitored cont<strong>in</strong>uously.Results12 registered nurses or above <strong>in</strong> our Day Centre have acquired this qualification s<strong>in</strong>ce the <strong>in</strong>ception of the tra<strong>in</strong><strong>in</strong>gprogramme. Nowadays, all the IV chemotherapy adm<strong>in</strong>istrations <strong>in</strong> Day Centre, <strong>in</strong>clud<strong>in</strong>g IV vesicant <strong>in</strong>jections, are doneby these specially tra<strong>in</strong>ed nurses. There were 6,782 chemotherapy adm<strong>in</strong>istrations <strong>in</strong> the year of 2011/12. Extravasation<strong>in</strong>cident rate ranged from 0 to 0.015% per annum <strong>in</strong> the past 10 years. However, no extravastion was committed by speciallytra<strong>in</strong>ed chemotherapy nurses s<strong>in</strong>ce the start of this practice. Corporate-wide core curriculum of chemotherapy nurse tra<strong>in</strong><strong>in</strong>gprogramme was developed <strong>in</strong> May 2012. Our programme served as a role model for this new corporate <strong>in</strong>itiative and otherlocal chemotherapy service centres as well. IV bolus <strong>in</strong>jection of cytotoxic vesicants is an advanced oncology nurs<strong>in</strong>gpractice. Poor performance will put both the patients and organisation at risk. Our experience has successfully demonstratedthe importance of well-constructed and formalised staff tra<strong>in</strong><strong>in</strong>g, periodic competency verification and cont<strong>in</strong>uous monitor<strong>in</strong>g<strong>in</strong> ensur<strong>in</strong>g the quality and safety of IV chemotherapy adm<strong>in</strong>istration, <strong>in</strong> particular, the vesicant <strong>in</strong>jection.
Service Priorities and <strong>Programme</strong>s Free PapersSPP6.6 Susta<strong>in</strong>able Workforce 10:45 Room 221Simulation Tra<strong>in</strong><strong>in</strong>g <strong>in</strong> Hospital Authority Central Intern Orientation <strong>Programme</strong> to Promote Patient Safety <strong>in</strong>Daily Hospital PracticeLo CCK 1, 2 , Chen PP 1, 2 , Wu C 3 , Szeto S 3 , Li CK 4 , Pang FC 51Department of Anaesthesiology and Operat<strong>in</strong>g Services, North District Hospital, 2 Institute of Cl<strong>in</strong>ical Simulation, Hong KongCollege of Anaesthesiologists, 3 Hospital Authority Institute of Healthcare, 4 Department of Paediatrics, Pr<strong>in</strong>ce of Wales hospital,5Hospital Authority Head OfficeHong KongIntroductionHospital Authority (HA) Central Intern Orientation <strong>Programme</strong> aims at prepar<strong>in</strong>g fresh medical graduates for hospital duties,transit<strong>in</strong>g from students to cl<strong>in</strong>icians with web-based lectures, basic life support, advanced cardiac life support and pre<strong>in</strong>ternshiphospital attachment. However, with grow<strong>in</strong>g awareness of patient safety, medical knowledge alone is not enoughfor prevent<strong>in</strong>g medical <strong>in</strong>cidents and provid<strong>in</strong>g best care to patients. Simulation is shown to be an effective educationaltool to stimulate adult learn<strong>in</strong>g, teach communication skills and teamwork, which are the keys of success <strong>in</strong> patient safety.In 2012, based on the past pilot workshops, we developed a one-and-half day simulation workshop to enhance <strong>in</strong>terns’competency <strong>in</strong> provid<strong>in</strong>g safe cl<strong>in</strong>ical practice.157HOSPITAL AUTHORITY CONVENTION 2013ObjectivesTo develop a simulation workshop which could: (1) heighten <strong>in</strong>terns’ awareness of patient safety <strong>in</strong> daily hospital practice;(2) understand the human behaviour <strong>in</strong> error, expla<strong>in</strong> different risk reduction strategies and policies <strong>in</strong> HA hospitals; and (3)<strong>in</strong>troduce effective communication tools and teamwork components for m<strong>in</strong>imis<strong>in</strong>g medical <strong>in</strong>cidents.MethodologyWorkshop was held <strong>in</strong> June (before commencement of <strong>in</strong>ternship) at North District Hospital. It <strong>in</strong>cluded three half-daymodules. Module one was called “systematic approach to safe bedside procedures”, which <strong>in</strong>cluded hands-on practice oflumbar puncture, chest tapp<strong>in</strong>g and pleural biopsy, arterial blood tak<strong>in</strong>g on manik<strong>in</strong>s, with scenario-based discussion on thetopic of “<strong>in</strong>formed consent”, “time-out” and “safe specimen handl<strong>in</strong>g”. Module two was “transfusion safety”, which <strong>in</strong>cludedhands-on practice of “type and screen”, blood adm<strong>in</strong>istration with 2D barcode verification, simulated transfusion reactionscenario for learn<strong>in</strong>g management, HA protocols and Advanced Incident Report<strong>in</strong>g System (AIRS), Situation, Background,Assessment and Recommendation (SBAR) communication tool and teamwork components <strong>in</strong> debrief<strong>in</strong>g. Module threewas “Medication safety”, which consisted of hands-on practice of prescription on MAR form, “three checks five rights”<strong>in</strong> drug adm<strong>in</strong>istration and transcription. Simulation of medication <strong>in</strong>cidents and problem-based discussion focused oncl<strong>in</strong>ical pitfalls dur<strong>in</strong>g drug prescription and adm<strong>in</strong>istration. 254 fresh graduates attended were requested to complete astandardised questionnaire at the end of workshop, items <strong>in</strong>cluded quality and appropriateness of workshop (Likert scalefrom one — strongly disagree to five — strongly agree) and self-rated competency and confidence before and after workshop(Wilcoson matched pairs signed rank test).Thursday, 16 MayResults250 <strong>in</strong>terns returned questionnaire (98.43% responded). The <strong>in</strong>terns found that workshop was well organised (4.33),relevant (4.46), and useful: safe bedside procedure (4.31), transfusion safety (4.29), medication safety (4.38). Their perceivedcompetency <strong>in</strong> topics covered and confidence on start<strong>in</strong>g <strong>in</strong>ternship <strong>in</strong>creased significantly (p
158HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP6.7 Susta<strong>in</strong>able Workforce 10:45 Room 221Medical Records Retrieval <strong>in</strong> Ophthalmology Cl<strong>in</strong>ic (EYE OPD)Tam WS 1 , Chan KY 1 , Wong YL 1 , Lee KWT 2 , Wong SYD 2 , Lam HMD 3 , Leung KFK 3 , Chan PCR 3 , Kwok TSD 3 , Yu CF 11Specialist Outpatient Department, United Christian Hospital, 2 Information Technology Department, United Christian Hospital,3Cl<strong>in</strong>ical Management Systems Team 6 , Hospital Authority Head OfficeHong KongIntroductionUpon patients’ arrival <strong>in</strong> the Specialist Outpatient Department (SOPD), Healthcare Assistant (HCA) staff should take up therelevant medical record (MR) with the appo<strong>in</strong>tment slips received from the counter, sort them by the appo<strong>in</strong>tment time orattendance time, and put <strong>in</strong> appropriate queues for consultation. The appo<strong>in</strong>tment slip is the only media to tell the HCA theattendance of patients. Usually the local MR storage is near the counter. However, s<strong>in</strong>ce the counter for United ChristianHospital (UCH) Ophthalmology Cl<strong>in</strong>ic (EYE OPD) moved to the ma<strong>in</strong> hall for central registration <strong>in</strong> 2011, the HCA staff had tocollect the scattered appo<strong>in</strong>tment slips from the counter, then travel 50 meters or more to the nurse station for MR retrieval.Tens of such walk<strong>in</strong>g each day causes not only OSH problems, but also <strong>in</strong>creases the chance of los<strong>in</strong>g appo<strong>in</strong>tment receipts.It <strong>in</strong> turn results <strong>in</strong> disclosure of patient privacy, and keeps the patient wait<strong>in</strong>g forever s<strong>in</strong>ce the HCA never knows thepatients’ presence.Objectives(1) To notify the HCA at local MR store on the arrival of patients, upon their registration us<strong>in</strong>g Outpatient Appo<strong>in</strong>tment System(OPAS) at counter; and (2) to guarantee no s<strong>in</strong>gle patient’s arrival is missed.Thursday, 16 MayMethodologyInspired by the workflow at Hong Kong style restaurants( 茶 餐 廳 ), a new and creative <strong>in</strong>formation technology (IT) solutionis developed by the UCH IT Department with great help from the OPAS team. When the patient registers, an attendanceslip will be pr<strong>in</strong>ted automatically at the MR storage. With this slip, the HCA can pick up the appropriate MR and queue forhim. It works like when you order a dish of 干 炒 牛 河 <strong>in</strong> a modern restaurant, an order slip is pr<strong>in</strong>ted at the kitchen so that thechef can cook accord<strong>in</strong>gly. That is why the new system has a nickname of“ 干 炒 牛 河 ”or“ 牛 河 機 ”. Besides a receipt pr<strong>in</strong>ter,the“ 牛 河 機 ”also <strong>in</strong>cludes a touch monitor tablet and a barcode scanner. When a medical record is collected, the HCA scansthe barcode on the MR or the slip. This makes sure no patients’ registration is missed. Special needs of patients (such aswheelchair or deaf) are also highlighted <strong>in</strong> the attendance slip. Better and more appropriate care of patients can be delivered.ResultsS<strong>in</strong>ce the launch of the new system <strong>in</strong> March 2012, no patient’s arrival is missed. The walk<strong>in</strong>g distance for the HCA is alsogreatly reduced. This not only <strong>in</strong>creases their job satisfactory, but also lowers the turnover rate of HCA staff.
Service Priorities and <strong>Programme</strong>s Free PapersSPP7.1 Modernisation of Healthcare 13:15 Room 221Experience of Us<strong>in</strong>g Hydrogen Peroxide Vaporisation for Prevent<strong>in</strong>g Environmental Transmission of the MultidrugResistant Organism — Vancomyc<strong>in</strong>-Resistant EnterococciHo OM 1 , Lai TW 2 , Tong WKD 1,2 , Hui WT 3 , Ng TK 31Hospital Authority Infectious Disease Centre, 2 Infection Control Team, Pr<strong>in</strong>cess Margaret Hospital, 3 Department of Pathology,Pr<strong>in</strong>cess Margaret Hospital, Hong KongIntroductionSeveral outbreaks of Vancomyc<strong>in</strong>-resistant enterococci (VRE) have occurred <strong>in</strong> Hospital Authority (HA) hospitals s<strong>in</strong>ce late2011. VRE poses risks to patients as it not only reduces therapeutic options, the resistance genes can also transfer fromenterococci to other gram-positive organisms, e.g. Methicill<strong>in</strong>-resistant Staphylococcus Aureus (MRSA). Among variouscauses, environmental contam<strong>in</strong>ation has been considered as an important factor lead<strong>in</strong>g to patient-to-patient transmission.Nevertheless, thorough environmental dis<strong>in</strong>fection rema<strong>in</strong>s a challenge because environmental surfaces are not easilyreachable by traditional cleans<strong>in</strong>g method us<strong>in</strong>g sodium hypochlorite. In response to this, the Hospital Authority InfectiousDisease Centre (HAIDC) has adopted a “hydrogen peroxide vaporisation” (HPV) bio-decontam<strong>in</strong>ation method for term<strong>in</strong>alenvironmental dis<strong>in</strong>fection where microbial components are killed by hydroxyl radical of H 2 O 2 . Apart from provid<strong>in</strong>g bettersurface coverage, the method leaves no toxic by-products and is compatible with electronics.159HOSPITAL AUTHORITY CONVENTION 2013ObjectivesTo prevent environmental transmission of VRE by thorough term<strong>in</strong>al environmental dis<strong>in</strong>fection.MethodologyThis procedure <strong>in</strong>volves five doma<strong>in</strong>s: seal<strong>in</strong>g, maximis<strong>in</strong>g exposure of surfaces, air circulation control, monitor<strong>in</strong>g dur<strong>in</strong>gdis<strong>in</strong>fection, and performance evaluation. A pre-procedure jo<strong>in</strong>t site-assessment was conducted by staff from the wardnurs<strong>in</strong>g team, <strong>in</strong>fection control team, Electrical and Mechanical Services Department (EMSD), facility management andmicrobiology laboratory. To prevent leakage of H 2 O 2 , the supply and exhaust grills of the room and door edges were sealedoff, and air-duct ventilation dampers were closed off. Patient care items were rearranged such that all surfaces could beexposed to H 2 O 2 . Industrial fans were placed <strong>in</strong> strategic positions to maximise distribution of H 2 O 2 . Hand-held sensor wasused to monitor leakage of H 2 O 2 . A biological <strong>in</strong>dicator that conta<strong>in</strong>s a high heat resistant spore was applied to measureeffectiveness of the procedure.ResultsFrom November 2011 to January 2013, 33 episodes of HPV bio-decontam<strong>in</strong>ation were performed <strong>in</strong> HAIDC. Each procedurelasted four to five hours. Us<strong>in</strong>g the biological <strong>in</strong>dicator as a measure of success, only one episode failed, mak<strong>in</strong>g a successfulrate of 97%. On the episode that failed, the spores on one of the biological <strong>in</strong>dicators were not completely killed and thatwas attributed to possible <strong>in</strong>adequate circulation of H 2 O 2 , and it was recommended that more attention be paid to aircirculation control to ensure adequate flow of H 2 O 2 across the room. Environmental decontam<strong>in</strong>ation plays an important role<strong>in</strong> prevention of transmission of VRE. The experience <strong>in</strong> HAIDC has shown that HPV is a feasible and effective approach tothorough term<strong>in</strong>al environmental dis<strong>in</strong>fection.Thursday, 16 May
160HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP7.2 Modernisation of Healthcare 13:15 Room 221The Patient Engagement <strong>Programme</strong> <strong>in</strong> Hong Kong — The Leg Club (Review and Forward)Lam KKA 1 , Ho CW 2 , Chan HY 1 , Wong KWJ 1 , Leung SKC 3 , Chu WSD 11Family Medic<strong>in</strong>e and Primary Healthcare, Hong Kong East Cluster, 2 Department of Surgery, Pamela Youde Nethersole EasternHospital, 3 Nurs<strong>in</strong>g Services Division, Pamela Youde Nethersole Eastern Hospital,Hong KongIntroductionMost patients who have varicose ve<strong>in</strong> are often due to their job that requires long stand<strong>in</strong>g or sitt<strong>in</strong>g. Over neglected oruntreated varicose ve<strong>in</strong> often ends up with venous hypertension and leg ulcer. Poor medical compliances and <strong>in</strong>appropriatewound management leads to hard-to-healed wounds.ObjectivesThe Leg Club aims to provide leg ulcer management <strong>in</strong> a social environment, where patients are treated <strong>in</strong>ter-discipl<strong>in</strong>ary andspecifically through social <strong>in</strong>teraction, participation, empathy and peer support where positive health beliefs are promoted.Thursday, 16 MayMethodologyThe “leg club” was firstly launched <strong>in</strong> Hong Kong East Cluster (HKEC), Anne Black Health Centre General Outpatient Cl<strong>in</strong>ic(GOPC), Wound Cl<strong>in</strong>ic by January 2011. It covered a list of <strong>in</strong>vestigation; wound management; limbs strengthen<strong>in</strong>g exercise;therapeutic and rehabilitation procedures, and patient education <strong>in</strong>volv<strong>in</strong>g family members. In addition, two volunteers (formerpatients) shared their experience through open discussion and mutual encouragement. A new targeted high risk group<strong>in</strong>clud<strong>in</strong>g patients like teacher, chef and salesperson who experienced heav<strong>in</strong>ess of extremity, dull ach<strong>in</strong>g sensation anddifferent degree of telangiectasias were recruited. All recruited patients were scheduled to come back at the fourth, 16 th , 32 ndand 52 nd week for follow-up.ResultsThere were 120 cases recruited <strong>in</strong> the Leg Club. Compared with 2011, the compliance rate on <strong>in</strong>dependent limb exercise,compression and leg elevation after the Leg Club were <strong>in</strong>creased. Patients managed their wounds themselves by woundmodernisation on bath<strong>in</strong>g and home dress<strong>in</strong>g. Heal<strong>in</strong>g score and patient satisfaction <strong>in</strong>dex were reported to be significantlyimproved by 80% and 93% respectively. In future, we aim at collect<strong>in</strong>g wound heal<strong>in</strong>g time, recurrence and level ofcompla<strong>in</strong>ts related to varicose ve<strong>in</strong>. Community programme is an essential component on deliver<strong>in</strong>g healthcare <strong>in</strong> primaryhealth sett<strong>in</strong>g. Leg Club will be launched to promote their self-care through peer effect.ConclusionsThroughout the Leg Club, the concept of socialisation with patient empowerment, peer and family support, will<strong>in</strong>gness toattend for systemic “well leg” checks, ongo<strong>in</strong>g health education and life modification dramatically speed up wound heal<strong>in</strong>gand reduce recurrence.
Service Priorities and <strong>Programme</strong>s Free PapersSPP7.3 Modernisation of Healthcare 13:15 Room 221Transcatheter Aortic Valve Implantation (TAVI) Queen Elizabeth Hospital Registry — A Multi-discipl<strong>in</strong>ary TeamApproachLee KYM 1 , Chan LK 1 , Chan KC 1 , Chui SF 1 , Ma HS 1 , Wong CY 1 , Chan KT 1 , Chiang CS 1 , Li P 1 , Lam CB 1 , Leung C 1 , Chan MC 1 ,Fan MY 1 , Leung KW 1 , Cheung HL 2 , Ma CC 2 , So E 3 , Fok D 3 , Chow YF 3 , Chan MK 4 , Chan W 4 , Chan S 41Department of Medic<strong>in</strong>e, 2 Department of Cardiothoracic Surgery, 3 Department of Anaesthesiology,4Department of Diagnostic Radiology and Imag<strong>in</strong>g, Queen Elizabeth Hospital, Hong KongIntroductionAortic stenosis (AS) is the most common valvular heart disease <strong>in</strong> the age<strong>in</strong>g population, with a prevalence of 4.6% <strong>in</strong> adults>75 years of age. When patients with severe AS become symptomatic and present with congestive heart failure, syncopeor chest pa<strong>in</strong>, they will have rapidly deteriorat<strong>in</strong>g functional class with high risk of sudden death. Two-year survival rateis only 30% to 40%. Surgical aortic valve replacement (SAVR) is the standard treatment for symptomatic AS patients butmany patients refused to have open heart surgery because of advanced age or underly<strong>in</strong>g co-morbidities. TranscatheterAortic Valve Implantation (TAVI) has recently been another treatment option for these patients. This <strong>in</strong>volves percutaneousimplantation of a porc<strong>in</strong>e aortic valve housed <strong>in</strong>side a nit<strong>in</strong>ol metal frame through the femoral or subclavian artery routeswithout subject<strong>in</strong>g the patients to open heart surgery or cardio-pulmonary bypass. Although a high risk procedure with 5% to10% of immediate complications and 30-day mortality of 5.6% to 12.7%, it reduces all-cause mortality by 25% at two years.161HOSPITAL AUTHORITY CONVENTION 2013ObjectivesTo assess the safety and feasibility of a high risk transcatheter procedure for <strong>in</strong>operable or high risk symptomatic aorticstenosis patients through a multi-discipl<strong>in</strong>ary team approach.MethodologyA multi-discipl<strong>in</strong>ary TAVI team compris<strong>in</strong>g cardiologists, cardiac surgeons, anaesthesiologists, radiologists and cardiacnurses, was formed <strong>in</strong> early 2010 <strong>in</strong> Queen Elizabeth Hospital. All potential patients would be <strong>in</strong>terviewed <strong>in</strong>dependently bythe cardiologists and cardiac surgeons. The TAVI Heart Team then decided whether the patient should undergo SAVR orTAVI. All patients were assessed by echocardiogram, trans esophageal echocardiogram (TEE), computerised tomographyscan and angiogram to decide their suitability. Echocardiogram and six-m<strong>in</strong>ute walk test would be performed accord<strong>in</strong>g toschedule. All complications would be reported to an <strong>in</strong>dependent Safety Monitor<strong>in</strong>g Committee. All data will be captured bythe local Queen Elizabeth Hospital Registry and the multi-centred Asia TAVI Registry.ResultsFrom December 2010 to February 2013, 22 patients (13 males and 9 females) with symptomatic severe aortic stenosisunderwent the TAVI procedure. Average age was 82.0±5.0 years. All procedures were done under general anaesthesia<strong>in</strong> our cardiac catheterisation laboratory and Hybrid Operat<strong>in</strong>g Room. Aortic valve area improved from 0.72±0.18cm2 to1.97±0.32cm2 and mean gradient decreased from 53.0±10.5mmHg to 9.3±3.0mmHg. All patients have only trivial to mildaortic regurgitation dur<strong>in</strong>g subsequent follow-up. Permanent pacemakers were implanted <strong>in</strong> three patients (13.6%). Onepatient was noticed to have subclavian artery subtotal occlusion after surgical repair with successful stent<strong>in</strong>g done. No othercomplications were noted. The <strong>in</strong>-hospital and 30-day mortality was 0%. After an <strong>in</strong>termediate-term mean follow-up of 13months (one month to 26 months), only one patient died of acute coronary syndrome at three months. All patients showedmarked symptomatic improvement on follow-up with 14% improved two New York Heart Association functional classes, 77%with one class and 9% with no change. This compares favourably with results from Asia and other parts of the world.Thursday, 16 MayConclusionsBe<strong>in</strong>g a high risk procedure, TAVI was shown to be safe and feasible <strong>in</strong> a group of high risk symptomatic severe AS elderliesthrough proper patient selection, meticulous procedural details and multi-discipl<strong>in</strong>ary team approach.
162Service Priorities and <strong>Programme</strong>s Free PapersHOSPITAL AUTHORITY CONVENTION 2013Thursday, 16 MaySPP7.4 Modernisation of Healthcare 13:15 Room 221Can Coat<strong>in</strong>g Ward Environment with Visible Light Activated Photocatalyst Reduce Hospital Acquired InfectionRate?Leung HB 1 , Chiu HY 2 , Kwok HY 31Department of Orthopaedics and Traumatology, Hong Kong West Cluster,2Central Nurs<strong>in</strong>g Department, Hong Kong West Cluster,3Department of Orthopaedics and Traumatology, Li Ka Sh<strong>in</strong>g Faculty of Medic<strong>in</strong>e, The University of Hong Kong,Hong KongIntroductionIt is well proven that hospital environment actually hosts a significant amount of micro-organism, <strong>in</strong>clud<strong>in</strong>g drug resistantpathogens. However, manag<strong>in</strong>g environmental microbial burden has received <strong>in</strong>adequate attention. There was a handfulof small-scaled studies <strong>in</strong>vestigat<strong>in</strong>g the usage of antibacterial material <strong>in</strong> ward, such as copper and silver. Outcomeassessment was quantitative culture from the coated surface. It is also impractical to utilise these alloys to coat the entirecl<strong>in</strong>ical area. These materials are also not compatible with post-hoc application, hence, most hospitals would not benefitfrom us<strong>in</strong>g these alloys. Furthermore, a huge gap exists between cl<strong>in</strong>ical outcome and the utilisation of these materials. Acommercially available spray coat, named Visible Light Activated Photocatalyst (VLAP) can decompose organic substance(<strong>in</strong>clud<strong>in</strong>g bacteria and viruses) by oxidative process when under illum<strong>in</strong>ation. Application is simple and is feasible <strong>in</strong> mostlocations. And upon fixation, the coat<strong>in</strong>g is resistant to wear. It has no consumption issue because it acts by catalysis,theoretically without depletion. And its oxidative process offers a broad spectrum bacteriocidal and virocidal effect. Thiscommercially available product has stood a good safety profile after launch<strong>in</strong>g for more than a decade. Despite it soundsideal as a means of <strong>in</strong>fection control, its efficacy was only proven <strong>in</strong> domestic and <strong>in</strong>dustrial sett<strong>in</strong>g, and there was no reporton its use <strong>in</strong> cl<strong>in</strong>ical sett<strong>in</strong>g.ObjectivesTo study if the use of VLAP as antibacterial coat<strong>in</strong>g for ward environment can lower microbial burden as well as <strong>in</strong>fection rate.MethodologyIt is a prospective randomised s<strong>in</strong>gle bl<strong>in</strong>ded controlled trial. Half of the male and female orthopaedic rehabilitation ward wasspray coated with VLAP. Bed allocation of <strong>in</strong>patients were randomised to these cubicles and they were cohorted for <strong>in</strong>fection,fever and prescribed with antibiotics dur<strong>in</strong>g their hospitalisation. Monthly monitor<strong>in</strong>g of the environmental bioburden wasassayed by adenos<strong>in</strong>e triphosphate lum<strong>in</strong>ometer.ResultsVLAP reduced the environmental microbial burden by 94.2% (4.8 relative light units vs 74.2 relative light units). 1,371 patientssatisfied the cohort criteria and contributed 22,328 bed days. The control group had ur<strong>in</strong>ary tract <strong>in</strong>fection, chest <strong>in</strong>fection,fever and antibiotic prescription episode as 0.797, 0.186, 0.379 and 1.05 per 100-bed-day respectively. Surgical site <strong>in</strong>fectionrate for clean surgery <strong>in</strong> the control group was 3.64%. VLAP reduced these parameters by 56.9%, 61.9%, 20.3%, 51.6% and53.0% respectively. No new onset of allergy or dermatitis were reported.ConclusionsVLAP effectively lowered environmental microbial burden. Cl<strong>in</strong>ical <strong>in</strong>fection rate and utilisation of antibiotics were alsoeffectively reduced.
Service Priorities and <strong>Programme</strong>s Free PapersSPP7.5 Modernisation of Healthcare 13:15 Room 221First Year of 24/7 Acute Stroke Unit (ASU) and Stroke Thrombolytic ServiceKwan WMM, Chang C, Mak WWW, Ip FTF, Chang RSK, Pang SYY, Hon SFK, Ho SL, Cheung RTFDivision of Neurology, Department of Medic<strong>in</strong>e, Queen Mary Hospital, Hong KongIntroductionIntravenous tissue plasm<strong>in</strong>ogen activator (IV-rtPA) has become the standard therapy for acute ischemic stroke (IS). From2009 to 2011, the stroke pathway of Queen Mary Hospital was enhanced to a 24/7 protocol (24 hours a day, seven days perweek) and patients eligible for thrombolysis were treated rout<strong>in</strong>ely.ObjectivesTo assess the feasibility of our service model, which <strong>in</strong>cluded a stroke pathway with collaboration among the Accident andEmergency Department, Acute Stroke Unit (ASU), front-l<strong>in</strong>e residents and neurologists utilis<strong>in</strong>g telemedic<strong>in</strong>e for the provisionof 24/7 IV-rtPA.MethodologyService and cl<strong>in</strong>ical data for all ASU admissions over 12 months were reviewed to determ<strong>in</strong>e: (1) The proportion of patients<strong>in</strong> whom workup could be completed and considered for IV-rtPA with<strong>in</strong> the therapeutic time-w<strong>in</strong>dow; (2) utilisation rate of IVrtPA;and (3) safety and efficiency of thrombolysis improved through telemedic<strong>in</strong>e.163HOSPITAL AUTHORITY CONVENTION 2013Results447 patients were admitted to ASU dur<strong>in</strong>g the study period, 86% (n=383) were diagnosed with stroke or transient ischemicattack upon discharge. About half of them (n=182, 48%) presented to hospital with<strong>in</strong> three hours of symptom onset, with66% (n=119) be<strong>in</strong>g IS. In 92% (n=110) of these cases, assessment for suitability of IV-rtPA could be completed before thethree-hour therapeutic w<strong>in</strong>dow expired. Out of these 110 patients, 46 (42%) had no contra<strong>in</strong>dications aga<strong>in</strong>st thrombolysis.Eventually, 94% of them (n=43) received treatment. Two cases with delayed presentations were also treated. A high utilisationrate of IV-rtPA could be achieved (16.3% <strong>in</strong> all IS patients and 36.1% <strong>in</strong> those presented with<strong>in</strong> three hours). The mean doorto-computedtomography (CT), CT-to-ASU or ASU-to-needle time was 29, 26 or 46 m<strong>in</strong>utes, respectively (mean door-toneedletime = 102, range 54 – 177 m<strong>in</strong>utes). The proportion of patients treated dur<strong>in</strong>g office hours by an on-site neurologistwas 49% and through after-hours telemedic<strong>in</strong>e support was 51%. There was no significant difference <strong>in</strong> door-to-needle time,outcome, mortality and complication rates between these two groups. In summary, our service model can facilitate a highdiagnostic accuracy, rapid assessment for stroke thrombolysis, reliable coverage and high utilisation rate of IV-rtPA, as wellas <strong>in</strong>corporated acute stroke management <strong>in</strong>to the core competency of front-l<strong>in</strong>e residents.Thursday, 16 May
164HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP7.6 Modernisation of Healthcare 13:15 Room 221See What Are Beh<strong>in</strong>d (SWAB): Four Factors Lead<strong>in</strong>g to Successful Changes <strong>in</strong> Swab Count<strong>in</strong>g Practice <strong>in</strong> Pr<strong>in</strong>ceof Wales HospitalMok YT, Lee WWOperat<strong>in</strong>g theatre, Pr<strong>in</strong>ce of Wales Hospital, Hong KongIntroductionSwab count<strong>in</strong>g is always the hot issue <strong>in</strong> the operat<strong>in</strong>g theatre. Swab rack was <strong>in</strong>troduced <strong>in</strong> the 1950s to facilitate accurateswab counts. However, it was banned <strong>in</strong> the United K<strong>in</strong>gdom from practice recently, due to <strong>in</strong>fection control and safetyissues.MethodologyA new transparent plastic box, sourced by Risk Management Division of the Pr<strong>in</strong>ce of Wales Hospital, was recommended tobe used <strong>in</strong>stead.The management was us<strong>in</strong>g Lew<strong>in</strong>’s (1948) theory of unfreez<strong>in</strong>g, mov<strong>in</strong>g and refreez<strong>in</strong>g <strong>in</strong> the change process. To makeuse of it effectively, it is very important to identify key factors lead<strong>in</strong>g to successful changes: empowerment, cooperation,communication and effectiveness.Thursday, 16 MayAt the beg<strong>in</strong>n<strong>in</strong>g, the leaders work together and empower the staff by manag<strong>in</strong>g their attention, mean<strong>in</strong>g, trust and self. Anevaluation questionnaire was distributed to all operat<strong>in</strong>g theatre (OT) staff <strong>in</strong> early April 2012 to evaluate the effectiveness ofnew swab count policy <strong>in</strong> view of easy handl<strong>in</strong>g of soiled gauze, quality of conta<strong>in</strong>er and quality of hold<strong>in</strong>g stand. It resultedas moderate acceptance level with quite a number of negative feedback, especially on the hold<strong>in</strong>g stand.As a result, a tailor-made trolley with an “<strong>in</strong>cl<strong>in</strong>ed-top” was designed. The new conta<strong>in</strong>er and holder have been on trial for sixmonths.ResultsWe conducted a cross sectional survey to OT staff after six months by ask<strong>in</strong>g them the satisfaction level of the change <strong>in</strong>new swab count<strong>in</strong>g practice. 42 questionnaires were collected. 95% of them were satisfactory with the change progress,and 92% agreed that their <strong>in</strong>put and suggestions about the change had been collected dur<strong>in</strong>g the process. More than 85%considered communications about the change were timely and relevant, and agreed that the process of implementation wasflexible and reactive.Thus, we successfully change our practice. 39 of them were not will<strong>in</strong>g to use the previous swab rack <strong>in</strong>stead of the newswab conta<strong>in</strong>er holder.ConclusionChange requires careful plann<strong>in</strong>g. Our project demonstrates that through empowerment, cooperation, communication andevaluation of effectiveness, we can certa<strong>in</strong>ly succeed with the change process.
Service Priorities and <strong>Programme</strong>s Free PapersSPP7.7 Modernisation of Healthcare 13:15 Room 221Dy<strong>in</strong>g at Home — A Cross-specialty Multi-discipl<strong>in</strong>ary Effort to Fulfill the Last Wish of Term<strong>in</strong>ally Ill PatientsNg JSC 1 , Lam PT 2 , Chiu PC 1 , Chan ICP 2 , Li KM 3 , Li P 3 , Lam WM 1 , Leung SH 4 , Yeung KC 5 , Chan KS 11Department of Medic<strong>in</strong>e, Haven of Hope Hospital, 2 Department of Medic<strong>in</strong>e and Geriatrics, United Christian Hospital,3Accident and Emergency Department, United Christian Hospital, 4 Nurs<strong>in</strong>g Services Division, United Christian Hospital,5Community Nurs<strong>in</strong>g Service Department, United Christian Hospital,Hong KongIntroductionPatients with term<strong>in</strong>al illness may prefer to stay at home rather than to be hospitalised dur<strong>in</strong>g the last days of life. There is acollaborative effort to support the choice of dy<strong>in</strong>g-at-home <strong>in</strong> Kowloon East Cluster (KEC), which <strong>in</strong>cludes: (1) the provisionof end-of-life care at home by KEC Virtual Ward <strong>Programme</strong> (VWP); and (2) verification of death with last office performed <strong>in</strong>Accident and Emergency Department (AED). KEC VWP is a programme with concerted effort of community nurs<strong>in</strong>g service(CNS), a specialist palliative care (PC) nurse seconded to CNS, a PC physician and a geriatrician as team members with onsitehome visit. Patient and family are supported by VWP until the dy<strong>in</strong>g moment at home, while a natural and peaceful dy<strong>in</strong>gprocess is facilitated <strong>in</strong> AED with avoidance of <strong>in</strong>vasive procedures and cardio-pulmonary resuscitation. The deceased bodyis reta<strong>in</strong>ed <strong>in</strong> hospital mortuary. Support to family <strong>in</strong> bereavement is offered. This programme has received very positivefeedback from the families.165HOSPITAL AUTHORITY CONVENTION 2013Objectives(1) To del<strong>in</strong>eate the characteristics of the patients participated <strong>in</strong> the programme; and (2) to review the palliative <strong>in</strong>terventionprovided to facilitate dy<strong>in</strong>g-at-home.MethodologyPatients who jo<strong>in</strong>ed the programme and deceased were <strong>in</strong>cluded for retrospective review. Data are collected from patient’scl<strong>in</strong>ical record for descriptive analysis.ResultsFrom November 2011 to December 2012, 10 patients who were recruited <strong>in</strong> the programme died at home and were verifieddead <strong>in</strong> the AED. The mean age was 84 years old, with male-to-female ratio of 3:7. N<strong>in</strong>e lived with family members and onewith friends. Six patients had term<strong>in</strong>al cancer and four had advanced organ failure (three with end-stage renal failure; onewith advanced heart failure). The median palliative performance scale was 30% (range 10% to 40%). Advanced care plann<strong>in</strong>gwas done for all participants, with advanced directive signed by two patients. The median and mean of the duration fromrecruitment to death were 16.5 days and 31.6 days respectively. The average frequency of nurs<strong>in</strong>g visit was once every 1.8days, and that of doctor visit be<strong>in</strong>g once every 7.9 days. Non-oral medication was applied at home dur<strong>in</strong>g the term<strong>in</strong>al phase,<strong>in</strong>clud<strong>in</strong>g use of parenteral hydration (eight patients) and drugs of subcutaneous and <strong>in</strong>tramuscular route (four patients) andper rectal route (four patients). Cont<strong>in</strong>uous carer education and emotional support were provided <strong>in</strong> all cases.Thursday, 16 MayConclusionWith a collaborative cross-specialty multi-discipl<strong>in</strong>ary effort, a holistic end-of-life care and dy<strong>in</strong>g-at-home is a possibleoption for patients with term<strong>in</strong>al illness.
166HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP8.1 Young HA Investigators Presentations 14:30 Room 221Pharmacist Steps to Integrated Care <strong>in</strong> High-risk Geriatrics — Ward Aged Patient Pharmacist Service (WardAPPS)Chu KY 1 , Pak CHH 1 , Mak YF 2 , Tse SF 3 , Lau SYR 3 , Ngai SC 4 , Lui TC 41Pharmacy Department, Kowloon Hospital, 2 Medic<strong>in</strong>e Department, Queen Elizabeth Hospital,3Department of Rehabilitation, Kowloon Hospital,4Community Nurs<strong>in</strong>g Services, Kowloon Hospital, Hong KongIntroductionIntegrated care model (ICM) has commenced <strong>in</strong> Kowloon Central Cluster (KCC) hospitals s<strong>in</strong>ce October 2011 to categoriseelderly patients with High Admission Risk Reduction <strong>Programme</strong> for the Elderly (HARRPE) score>=0.2, which accounted for20% risk of emergency admission <strong>in</strong> 28 days. These high-risk elderly are prone to drug-related problems (DRP) <strong>in</strong>clud<strong>in</strong>gpolypharmacy, non-compliance, <strong>in</strong>teractions and adverse drug events. WardAPPS is a service that pharmacists proactivelyreview the medications of geriatric <strong>in</strong>patients under ICM and conduct an effective medication review by collaborat<strong>in</strong>g withphysicians.Objectives(1) To identify reconciliation errors; (2) to identify DRP and advise potential mitigation solutions; and (3) to provide medicationcounsell<strong>in</strong>g to patients.Thursday, 16 MayMethodologyICM office <strong>in</strong>formed pharmacy about patients with HARRPE>=0.2 <strong>in</strong> 5A medical extended care ward <strong>in</strong> Kowloon Hospital.The pharmacist performed cl<strong>in</strong>ical medication review three sessions weekly to identify any reconciliation errors or DRP andto assess patient compliance. Weekly grand round was performed by pharmacist and geriatrician. Appropriate pharmacist<strong>in</strong>terventions were made to patients, prescribers, nurses or ICM office and were documented <strong>in</strong> a web-based programme.ResultsFrom July to December 2012, a total of 238 patients (44.5% male, 47.5% old-aged home residents) were studied. Their meanage was 83.2±9.8 and HARRPE score was 0.36±0.13. Reconciliation error of admission and discharge reconciliation wasperformed <strong>in</strong> 238 (100%) and 42 patients (17.6%) respectively. There were 16 reconciliation errors (6.7%) identified, with 11errors (68.8%) caused by omission of drugs. 12 (75.0%) pharmacist <strong>in</strong>terventions were accepted by prescribers. 78 DRPswere found <strong>in</strong> 238 patients and were classified accord<strong>in</strong>g to Pharmaceutical Care Network Europe(PCNE).Treatment effectiveness: 54 (69.2%); adverse reactions: 20 (25.7%); treatment costs: 4 (5.1%), 8 (10.3%) and 53 (67.9%) DRPswere rated as serious and significantly severe. 85 pharmacist <strong>in</strong>terventions were made. Among these, 41 <strong>in</strong>terventions weremade to prescribers <strong>in</strong> which 37 (90.2%) were approved that led to 36 drug regimen changes. There were 27 drug <strong>in</strong>formationprovided to prescribers and 17 drug compliance counsell<strong>in</strong>g delivered to patients/carers. 6 (7.7%) and 55 (70.5%) pharmacistrecommendations were classified as contribut<strong>in</strong>g very significant and significant value <strong>in</strong> patient care. 46 patients/carersreceived <strong>in</strong>dividualised drug education and 13 patients received discharge counsell<strong>in</strong>g. Doctors, nurses and patientsgenerally agreed WardAPPS could optimise pharmacological management of geriatrics.ConclusionsWardAPPS is a pioneer<strong>in</strong>g service <strong>in</strong> Hong Kong to <strong>in</strong>volve pharmacists <strong>in</strong> manag<strong>in</strong>g high-risk geriatrics. Over 75% DRPswith significant severity were prevented. Pharmacists contribute notably to improve medication safety and therapeuticoutcomes. We also establish effective patient medication counsell<strong>in</strong>g and implement multi-discipl<strong>in</strong>ary care <strong>in</strong> geriatrics.
Service Priorities and <strong>Programme</strong>s Free PapersSPP8.2 Young HA Investigators Presentations 14:30 Room 221Evaluation of Sk<strong>in</strong>-to-sk<strong>in</strong> Contact <strong>in</strong> Neonatal Ward from Parents’ and Nurses’ PerspectivesLo KY, Chan OPH, Fung PC, Leung SFI, Liong MT, Man KLA, Tse YW, Wong MSM, Wong WFDepartment of Paediatrics, Queen Elizabeth Hospital, Hong KongIntroductionParents are stressed and anxious when their newborns are admitted to the neonatal ward. To support these mothers and<strong>in</strong>fants <strong>in</strong> the special care unit, we <strong>in</strong>troduce the practice of sk<strong>in</strong>-to sk<strong>in</strong> contact (SSC). SSC is to provide an <strong>in</strong>timate contactof the newborn with mother or father by plac<strong>in</strong>g the baby on their chest. SSC is an evidence-based <strong>in</strong>tervention for reduc<strong>in</strong>gseparation-dependent stress, enhanc<strong>in</strong>g parental-<strong>in</strong>fant bond<strong>in</strong>g and strengthen<strong>in</strong>g parental role. In addition, SSC also haspositive physical and emotional effects on both mothers and neonates.ObjectivesTo evaluate the concerns of parents and nurses after launch<strong>in</strong>g the SSC, and then identify areas for improvement.Methodology(1) Pre- and post-questionnaires for parents after the first experience of SSC; and (2) questionnaires were distributed tonurses six weeks after the implementation of SSC.167HOSPITAL AUTHORITY CONVENTION 2013Results35 parents completed the questionnaire. 62.9% were mothers. 37.1% were fathers. The average <strong>in</strong>fant hold<strong>in</strong>g time was 90m<strong>in</strong>utes. Parents <strong>in</strong>creased confidence <strong>in</strong> car<strong>in</strong>g babies from 47.1% to 91.5% after SSC. All the parents reported that SSCserved to enhance parental-<strong>in</strong>fant bond<strong>in</strong>g. they had more confidence <strong>in</strong> stabilis<strong>in</strong>g baby’s physical status; baby cried lessand slept better. Parents ma<strong>in</strong>ly concerned about their baby’s condition and safety. Moreover, parents were less stressfuldur<strong>in</strong>g SSC. 100% parents agreed that it was an enjoyable experience, especially the fathers. Overall parents’ satisfactionof SSC was significantly raised after the practice. 90.9% nurses understood the purpose of the practice and 78.1%nurses reported that the programme was worthwhile. 81.8% nurses acknowledged that SSC was beneficial to prematurebabies; however, 27.3% nurses reflected that there were not enough resources to support the practice. After analys<strong>in</strong>g thequestionnaires, suggestions were made to streaml<strong>in</strong>e the implementation of SSC. They <strong>in</strong>cluded purchas<strong>in</strong>g five new chairsto enhance parental comfort; <strong>in</strong>stallation of ceil<strong>in</strong>g mount curta<strong>in</strong> to promote privacy; enhancement of cl<strong>in</strong>ical observationat bedside to reduce parents’ worries; extend<strong>in</strong>g visit<strong>in</strong>g hours to encourage parents’ participation; hold<strong>in</strong>g regular meet<strong>in</strong>gfor nurses to further evaluate and identify the areas for improvement. Nurses play a major role <strong>in</strong> deliver<strong>in</strong>g family-centredcare. SSC is not only provided for the neonates, but also beneficial to the parents. We will cont<strong>in</strong>ue striv<strong>in</strong>g for quality familycentredcare <strong>in</strong> our unit.Thursday, 16 May
168HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP8.3 Young HA Investigators Presentations 14:30 Room 221Meet<strong>in</strong>g Needs, Fill<strong>in</strong>g Gaps: An Integration of a Written Pamphlet and a Multimedia Orientation <strong>Programme</strong> toPatients to Promote Cont<strong>in</strong>uous Quality Improvement <strong>in</strong> Surgical WardNg YHG, Wong SLE, Lam CP, Yeung W, Law WS, Chui STDepartment of Surgery, Pr<strong>in</strong>ce of Wales Hospital, Hong KongIntroductionSurgical wards receive a lot of emergency and cl<strong>in</strong>ical admissions for operations or <strong>in</strong>vestigations everyday. Most of thepatients do not understand the general guidel<strong>in</strong>es for admissions. In order to promote a better service to our patients as wellas m<strong>in</strong>imis<strong>in</strong>g duplicated works among nurs<strong>in</strong>g and support<strong>in</strong>g staff, a detailed <strong>in</strong>formation session is needed to enhancetheir knowledge upon admission. This tailor-made admission video and written pamphlet give patients <strong>in</strong>formation they need<strong>in</strong> an easy and understandable way.Objectives(1) To promote better services and knowledge to our patients and their relatives; (2) to avoid duplicated works among wardstaff; and (3) to act as a multimedia guide to facilitate patients and their relatives to understand further ward environment andoperations.Thursday, 16 MayMethodologyA tailor-made video programme and written pamphlet have been <strong>in</strong>troduced to surgical patients s<strong>in</strong>ce 2011 and the contents<strong>in</strong>side were discussed among each nurs<strong>in</strong>g staff <strong>in</strong> ward. This n<strong>in</strong>e-m<strong>in</strong>ute role-played video <strong>in</strong>cluded five ma<strong>in</strong> categories:(1) ward nature; (2) ward environment; (3) ward operation; (4) ward protection time of adm<strong>in</strong>istration of medic<strong>in</strong>e; and (5) ward<strong>in</strong>fection control measures. Patients <strong>in</strong> emergency or cl<strong>in</strong>ically admitted to ward would be given this video session or writtenpamphlet; and a self-rated questionnaires were taken pre- and post-programme.ResultsPatients who met the <strong>in</strong>clusion criteria were <strong>in</strong>vited to participate the programme from 2011 to 2012. Their demographicand basel<strong>in</strong>e understand<strong>in</strong>g of ward sett<strong>in</strong>gs were compared. More than 90% of patients showed more familiar to wardenvironment and operations after the programme (Wilcoxon Signed Ranks Test for pre- and post-questions, p
Service Priorities and <strong>Programme</strong>s Free PapersSPP8.4 Young HA Investigators Presentations 14:30 Room 221New Radiation-free Era <strong>in</strong> Reflux Imag<strong>in</strong>g for Paediatric Ur<strong>in</strong>ary Tract Infection (UTI): Void<strong>in</strong>g Urosonographywith Intravesical Ultrasound Contrast — First Local Pilot StudyTse KS 1 , Wong LS 1 , Fan TW 1 , Kwok KY 1 , Chan W 2 , Leung MWY 3 , Chao N 3 , Tsang TK 1 , Fung HS 1 , Tang KW 1 , Chan SCH 11Department of Radiology and Imag<strong>in</strong>g, 2 Department of Paediatrics, 3 Division of Paediatric Surgery,Department of Surgery, Queen Elizabeth Hospital, Hong KongIntroductionVesicoureteric reflux (VUR) is an important cause of paediatric ur<strong>in</strong>ary tract <strong>in</strong>fection (UTI), which is traditionally diagnosedby fluoroscopic micturat<strong>in</strong>g cystourethrography (MCU). However children are more susceptible to long term side effectsfrom radiation exposure. Therefore void<strong>in</strong>g urosonography (VUS) has emerged as a valid radiation-free alternative to MCU<strong>in</strong> Europe. VUS is technically similar to MCU, except the <strong>in</strong>travesical use of ultrasound contrast and cont<strong>in</strong>uous sonographicexam<strong>in</strong>ation of upper ur<strong>in</strong>ary tract for reflux detection, with no radiation exposure.ObjectivesTo <strong>in</strong>vestigate the diagnostic accuracy, reliability, safety and feasibility of VUS <strong>in</strong> diagnos<strong>in</strong>g vesicoureteric reflux ascompared to MCU.169HOSPITAL AUTHORITY CONVENTION 2013MethodologyPatients under five years old, present<strong>in</strong>g with first episode of UTI <strong>in</strong> our <strong>in</strong>stitution from September 2010 to August 2012 wererecruited. All <strong>in</strong>cluded subjects were arranged renal ultrasound and VUS, followed by MCU, performed by two groups ofpaediatric radiologists and sonographer. The follow<strong>in</strong>g parameters were assessed: (1) detection and grad<strong>in</strong>g of vesicouretericreflux; (2) <strong>in</strong>terobserver agreement (VUS); (3) complication rate; (4) procedural duration; and (5) radiation dose (MCU).Results31 patients (Male=74%, Female=26%) and 62 kidney-ureter units (KUUs) were exam<strong>in</strong>ed. Their mean age was 8.87 months.Vesicoureteric reflux was demonstrated <strong>in</strong> 14 KUUs (22.6%), five by both methods and n<strong>in</strong>e by VUS alone, i.e. MCU detectedonly five refluxes and missed n<strong>in</strong>e refluxes. There was significant difference <strong>in</strong> reflux detection rate (p
170HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP8.5 Young HA Investigators Presentations 14:30 Room 221Less is More: A Simple Chest Dra<strong>in</strong> Site Dress<strong>in</strong>g is Good EnoughWong PSF, Lai JH, Chan WL, Ma CCDepartment of Cardiothoracic Surgery, Queen Elizabeth Hospital, Hong KongIntroductionMany clients are transferred to our unit with very clumsy and unhandy chest dra<strong>in</strong> site dress<strong>in</strong>gs. We spend a lot of time onremov<strong>in</strong>g the dress<strong>in</strong>gs yet this always causes unpleasant and pa<strong>in</strong>ful experience to clients. This k<strong>in</strong>d of dress<strong>in</strong>gs br<strong>in</strong>g noadvantage <strong>in</strong> terms of prevent<strong>in</strong>g dislodgement of the chest dra<strong>in</strong> tube.Objectives(1) To maximise clients’ comfort with dress<strong>in</strong>g; (2) to utilise dress<strong>in</strong>g materials efficiently and effectively; and (3) to secure thechest dra<strong>in</strong> tube safely.Methodology(1) A direct observation technique was utilised. Every client with a simple chest dra<strong>in</strong> site dress<strong>in</strong>g will be assessed onceper shift us<strong>in</strong>g a chest dra<strong>in</strong> observation chart. It can help to ensure the proper position of a chest tube. (2) Face-to-face<strong>in</strong>terviews were implemented. Clients were <strong>in</strong>terviewed about the differences of the two dress<strong>in</strong>gs <strong>in</strong> terms of comfort,irritability and stability. Nurs<strong>in</strong>g staff were <strong>in</strong>terviewed about the ease of chang<strong>in</strong>g the two different types of chest dra<strong>in</strong> sitedress<strong>in</strong>gs and <strong>in</strong>cidence of dislodgement of the chest tube with a simple dress<strong>in</strong>g.Thursday, 16 MayResults10 clients and all cl<strong>in</strong>ical nurs<strong>in</strong>g staff were <strong>in</strong>terviewed from March to August 2012. All clients preferred a simple chestdra<strong>in</strong> site dress<strong>in</strong>g to the clumsy one s<strong>in</strong>ce a simple dress<strong>in</strong>g used less adhesive materials, thus it usually caused no sk<strong>in</strong>allergy. It also covered less body surface area, so clients’ body movement would not be restricted. Nurs<strong>in</strong>g staff chose asimple dress<strong>in</strong>g as well because it was easy and convenient to be changed, time could be saved to perform other nurs<strong>in</strong>gprocedures. As less dress<strong>in</strong>g materials were used, the cost effectiveness requirement could be met. Lastly, no <strong>in</strong>cident ofchest tube displacement with a simple dress<strong>in</strong>g was reported.ConclusionA simple chest dra<strong>in</strong> site dress<strong>in</strong>g used <strong>in</strong> our department is good enough <strong>in</strong> provid<strong>in</strong>g clients’ comfort yet at the same timeensur<strong>in</strong>g correct chest tube placement. It can prevent our clients from unnecessary suffer<strong>in</strong>gs and provide our staff with aneat environment for wound care. S<strong>in</strong>ce it is an era of quality care, provid<strong>in</strong>g simple and effective surgical nurs<strong>in</strong>g care isessential <strong>in</strong> order to fulfill the ma<strong>in</strong> theme of this year convention “Consolidat<strong>in</strong>g HealthcAre”.
Service Priorities and <strong>Programme</strong>s Free PapersSPP8.6 Young HA Investigators Presentations 14:30 Room 221Use of Water Swallow<strong>in</strong>g Test as a Screen<strong>in</strong>g Tool <strong>in</strong> Acute Stroke UnitWong AYH 1 , Ip F 2 , Wong R 11Speech Therapy Department, 2 Neurology Department, Queen Mary Hospital, Hong KongIntroductionThe prevalence of dysphagia varied from 37% to 78% <strong>in</strong> patients after stroke. Dysphagia <strong>in</strong>creases the risk of aspirationpneumonia. Early identification of aspiration <strong>in</strong> stroke like dysphagia screen<strong>in</strong>g and water swallow<strong>in</strong>g test is essential.Many researches documented the usefulness of water swallow<strong>in</strong>g tests <strong>in</strong> stroke population. Recent literature has reviewedthe correlation of accuracy when perform<strong>in</strong>g a dysphagia screen<strong>in</strong>g between nurses and speech therapists. However, nolocal study has been done to compare the results of water swallow<strong>in</strong>g test adm<strong>in</strong>istered by nurses and formal swallow<strong>in</strong>gassessments by speech therapists.Objectives(1) To <strong>in</strong>vestigate the reliability of water swallow<strong>in</strong>g test performed by nurses <strong>in</strong> acute stroke unit; and (2) to explore itseffectiveness to serve as a screen<strong>in</strong>g tool to m<strong>in</strong>imise aspiration risks.171HOSPITAL AUTHORITY CONVENTION 2013Methodology649 acute stroke patients admitted to acute stroke unit were recruited. Each patient was first fed by nurses with 25ml waterby teaspoon <strong>in</strong> five consecutive trials. He/she was then asked to dr<strong>in</strong>k the rema<strong>in</strong><strong>in</strong>g 25ml water via cup. With<strong>in</strong> the next 48hours, patient’s swallow<strong>in</strong>g ability was assessed by speech therapist. A cod<strong>in</strong>g system was used to <strong>in</strong>dicate the presenceof chok<strong>in</strong>g on patient’s <strong>in</strong>take of water by teaspoon and cup dr<strong>in</strong>k<strong>in</strong>g. Inter-rater agreement on these cod<strong>in</strong>g between twoprofessionals was computed to evaluate the reliability of water swallow<strong>in</strong>g test.ResultsWater swallow<strong>in</strong>g test performed by nurses <strong>in</strong> the present study had a sensitivity of 76% and specificity of 99% for detect<strong>in</strong>gaspiration <strong>in</strong> acute stroke unit. Moderate Kappa’s agreement was obta<strong>in</strong>ed on nurses’ and speech therapists’ cod<strong>in</strong>g,reach<strong>in</strong>g 0.685 (p
172HOSPITAL AUTHORITY CONVENTION 2013Service Priorities and <strong>Programme</strong>s Free PapersSPP8.7 Young HA Investigators Presentations 14:30 Room 221How Can Watch-PAT Adopt the “WIN” StrategyYiu KC 1 , So WY 2 , Ha SCN 2 , Lee DLY 2 , Abdullah VJ 2, 3 , van Hasselt CA 31Nurs<strong>in</strong>g Services Division, United Christian Hospital, 2 Department of Ear, Nose and Throat, United Christian Hospital,3Department of Otorh<strong>in</strong>olaryngology, Head and Neck Surgery, The Ch<strong>in</strong>ese University of Hong KongHong KongIntroductionObstructive Sleep Apnea (OSA) is a common sleep disorder affect<strong>in</strong>g 2% of middle-aged women and 4% of middle-agedmen <strong>in</strong> Hong Kong. For diagnostic of OSA, overnight polysomnography (PSG) sleep study is the gold standard but it is labour<strong>in</strong>tensive and resource demand<strong>in</strong>g. OSA patients are usually put on long wait<strong>in</strong>g list for overnight PSG <strong>in</strong> hospital. HenceWatch-PAT, which is a screen<strong>in</strong>g tool for OSA, is used <strong>in</strong>stead. It is designed as a portable and simple wrist-worn mach<strong>in</strong>e sothat sleep study can be carried out by patients at home without hospitalisation.ObjectivesTo explore the effectiveness of Watch-PAT prior to the prelim<strong>in</strong>ary impact on the services after implement<strong>in</strong>g the RentalScheme of Watch-PAT at Ear, Nose and Throat (ENT) Department.Thursday, 16 MayMethodologyThe accuracy of Watch-PAT data acquisition alongside a full PSG for OSA patients was <strong>in</strong>vestigated. Eventually, the RentalScheme of Watch-PAT comb<strong>in</strong>ed with education session by nurses was launched at ENT Department and therefore Watch-PAT could be manipulated by suspected OSA patients at home. The project was contemplated by the “WIN” strategy: Watch-PAT, <strong>in</strong>patient, and nurse.Results(1) Effectiveness of Watch-PAT: From 2010 to 2012, 48 patients with daytime sleep<strong>in</strong>ess and snor<strong>in</strong>g were recruited. BothWatch-PAT and PSG were undergone <strong>in</strong> the same night at Ward. Statistically, it demonstrated good reliability as Watch-PAT only slightly overestimated the respiratory disturbance <strong>in</strong>dex of 4.25 on average (p
The Government of the HKSARBooth No.Electrical and Mechanical Services Department 34Food and Health Bureau,Research Fund Secretariat 35Hospital AuthorityHA Community Health Call Centre 36A.R. Medicom Inc (Asia) Ltd. 31Floor Plan For ExhibitionsVenue: Convention Foyer, Theatre Foyer and Mezzan<strong>in</strong>e Floor, Hong Kong Convention and Exhibition CentreOpen<strong>in</strong>g Hours: 15 May 2013: 0845 – 173016 May 2013: 0845 – 1730Booth No.Great Eastern Healthcare Ltd. 29Janley Limited 8 to 10Johnson & Johnson (HK) Limited 12 to 14Just Med Limited 16Maquet Hong Kong Limited 21173HOSPITAL AUTHORITY CONVENTION 2013Abbott Laboratories Ltd. 32 & 33Advantech Automation Corp. (HK) Ltd. 11Alcatel-Lucent 24ANZ Bank<strong>in</strong>g Group Limited 28ArjoHuntleigh (Hong Kong) Limited 18 & 19Associated Medical Supplies Co., Ltd. 37Citibank (Hong Kong) Ltd. 38Draeger Medical Hong Kong Ltd. 30Million Tech Development Ltd. 27Olympus Hong Kong & Ch<strong>in</strong>a Ltd. 1 to 4ONKA (H.K.) Co., Ltd.22 & 22APacific Medical Systems Ltd. 17School of Public Health, The University of Hong Kong 26The Jockey Club School of Public Health and Primary Care, 25The Ch<strong>in</strong>ese University of Hong KongGE Healthcare5 to 7AUltronics Enterprise Limited 23Get<strong>in</strong>ge Hong Kong Company Limited 20Vik<strong>in</strong>g Group (HK) Ltd. 15Convention FoyerTheatre FoyerMezzan<strong>in</strong>e FloorTheatreFoyerConvention FoyerMezzan<strong>in</strong>eFoyer
174HOSPITAL AUTHORITY CONVENTION 2013ExhibitorsA.R. Medicom Inc. (Asia) Ltd. Booth No: 31Address: 21/F., Federal Centre, 77 Sheung On Street, ChaiWan, Hong Kong.Contact Person: Ms. Irene KEUNG, Assistant Sales ManagerTel: (852) 2179 7170 Fax: (852) 2147 4665Email: ikeung@medicom-asia.comAbbott Laboratories Ltd. Booth No: 32 – 33Address: 20/F., AIA Tower, 183 Electric Road, North Po<strong>in</strong>t,Hong Kong.Contact Person: Mr. Terry IP, Product SpecialistTel: (852) 9222 6372 Fax: (852) 2219 8066Email: terry.ip@abbott.comAdvantech Automation Corp. (HK) Ltd. Booth No: 11Address: Unit 1601, 16/F., West<strong>in</strong> Centre, 26 Hung To Road,Kwun Tong, Kowloon, Hong Kong.Contact Person: Mr. Bill LAN, Key Account ManagerTel: (852) 2720 5118 Fax: (852) 2720 8013Email: bill.lan@advantech.comAlcatel-Lucent Booth No: 24Address: 12/F., South Somerset House, Taikoo Place, 979K<strong>in</strong>g’s Road, Quarry Bay, Hong Kong.Contact Person: Ms. Ivy TSE, Assistant Market<strong>in</strong>g ManagerTel: (852) 2599 2590, (852) 6689 0073 Fax: (852) 2599 2573Email: ivy.tse@alcatel-lucent.comANZ Bank<strong>in</strong>g Group Ltd. Booth No: 28Address: 13/F., Three Exchange Square, 8 Connaught Place,Central, Hong Kong.Contact Person: Ms. Branda WONG, Team Head, Bus<strong>in</strong>essDevelopment TeamTel: (852) 3918 2091 Fax: (852) 3918 2991Email: branda.wong@anz.comArjoHuntleigh (Hong Kong) Limited Booth No: 18 – 19Address: 2909-16, 29/F., Tower 1, Kowloon Commerce Centre,51 Kwai Cheong Road, Kwai Chung, New Territories,Hong Kong.Contact Person: Mr. Kandy LOO, General ManagerTel: (852) 2207 6363 Fax: (852) 2207 6368Email: kandy.loo@arjohuntleigh.comAssociate Medical Supplies Co., Ltd. Booth No: 37Address: Room 1201, Fo Tan Industrial Centre, 26 Au Pui WanStreet, Fo Tan, New Territories, Hong Kong.Contact Person: Mr. Sanny W. K. IP, Deputy General ManagerTel: (852) 2604 9389 Fax: (852) 2694 0866Email: sales@amscl.comCitibank (HK) Ltd. Booth No: 38Address: 6/F., Dorset House, Taikoo Place, 979 K<strong>in</strong>g’s Road,Quarry Bay, Hong Kong.Contact Person: Ms. Rita YIP, Assistant ManagerEmail: rita.ky.yip@citi.comDraeger Medical Hong Kong Ltd. Booth No: 30Address: Room 1701 – 02, 17/F., Apec Plaza,49 Hoi Yuen Road, Kwun Tong, Kowloon, Hong Kong.Contact Person: Mr. Benny SY, Regional ManagerTel: (852) 2877 3077 Fax: (852) 2877 3066Email: benny.sy@draeger.comGE HealthcareBooth No: 5 – 7AAddress: L12 Office Tower, Langham Place, 8 Argyle Street,Mong Kok, Kowloon, Hong Kong.Contact Person: Ms. Jocelyn CHUNG, Sales DirectorTel: (852) 2100 6332 Fax: (852) 2100 6292Email: jocelyn.chung@ge.comGet<strong>in</strong>ge Hong Kong Company Limited Booth No: 20Address: 2909 – 16, 29/F., Tower 1, Kowloon CommerceCentre, 51 Kwai Cheong Road, Kwai Chung,New Territories, Hong Kong.Contact Person: Mr. Alex WONG, General ManagerTel: (852) 2207 6328 Fax: (852) 2207 6338Email: alex.wong@get<strong>in</strong>ge.comGreat Eastern Healthcare Ltd. Booth No: 29Address: 9/F., Block A, Kerry TC Warehouse One, 3 K<strong>in</strong> ChuenStreet, Kwai Chung, New Territories, Hong Kong.Contact Person: Mr. V<strong>in</strong>cent CHEUNG, Sales ManagerTel: (852) 2481 8832 Fax: (852) 2610 1483Email: v<strong>in</strong>cent@gehl.com.hkJanley Limited Booth No: 8 – 10Address: Room 1103, TCL Tower, 8 Tai Chung Road,Tsuen Wan, New Territories, Hong Kong.Contact Person: Mr. Yeo TAI, Product SpecialistTel: (852) 2487 7077; (852) 9435 4812 Fax: (852) 2487 7090Email: yeo@janley.com.hkJohnson & Johnson (HK) Ltd. – Booth No: 12 – 14Medical DivisionAddress: Room 1001 – 1009, 10/F., Tower 2, Grand CenturyPlace, 193 Pr<strong>in</strong>ce Edward Road West, Mong Kok,Kowloon, Hong Kong.Contact Person: Mr. Roddick YUEN, Product ManagerTel: (852) 6082 4482 Fax: (852) 2736 8697Email: ryuen@its.jnj.comJust Med Limited Booth No: 16Address: 23/F, On Dak Industrial Build<strong>in</strong>g, 2 – 6 Wah S<strong>in</strong>gStreet, Kwai Chung, New Territories, Hong Kong.Contact Person: Mr. Terence Yung, Sales & Market<strong>in</strong>g ManagerTel: (852) 2742 4370, (852) 6376 0816 Fax: (852) 2786 1405Email: terenceyung@justmed.com.hkMaquet Hong Kong Ltd. Booth No: 21Address: 2909 – 16, 29/F., Tower 1, Kowloon Commerce Centre,51 Kwai Cheong Road, Kwai Chung, New Territories,Hong Kong.Contact Person: Mr. C M LEUNG, Manag<strong>in</strong>g DirectorTel: (852) 2207 6111 Fax: (852) 2207 6112Email: cm.leung@maquet.com
Million Tech Development Limited Booth No: 27Address: Unit D, 2/F., Leroy Plaza, 15 Cheung Shun Street,Cheung Sha Wan, Kowloon, Hong Kong.Contact Person: Mr. Nelson TSE, Sales & Market<strong>in</strong>g DirectorTel: (852) 2784 2868; (852) 2784 2803 Fax: (852) 2319 2967Email: nelsont@milliontech.comOlympus Hong Kong & Ch<strong>in</strong>a Limited Booth No: 1 – 4Address: L43, Office Tower, Langham Place, 8 Argyle Street,Mong Kok, Kowloon, Hong Kong.Contact Persons: Ms. Karis Tsui, Market<strong>in</strong>g ManagerTel: (852) 2170 5684; (852) 9058 1777 Fax: (852) 2170 5679Email: karis.tsui@ohc.olympus.com.hkONKA (H.K.) Co., Ltd.Booth No: 22 – 22AAddress: Room 1204, 12/F., Vanta Industrial Centre,21 – 33 Tai L<strong>in</strong> Pai Road, Kwai Chung, Hong Kong.Contact Person: Mr. Denis CHAN, DirectorTel: (852) 2886 0835 Fax: (852) 2421 8329Email: onkadc1616@yahoo.com.hkPacific Medical Systems Ltd. Booth No: 17Address: Room 2501 – 04, Two Ch<strong>in</strong>achem Exchange Square,338 K<strong>in</strong>g’s Road, North Po<strong>in</strong>t, Hong Kong.Contact Person: Ms. Viola CHAN, Sales & Market<strong>in</strong>gAdm<strong>in</strong>istratorTel: (852) 2108 4005 Fax: (852) 2547 6592Email: viola.chan@pacificmedicalsystems.comExhibitorsThe Jockey Club School of Booth No: 25Public Health and Primary Care,The Ch<strong>in</strong>ese University of Hong KongAddress: 2/F., School of Public Health, Pr<strong>in</strong>ce of Wales Hospital,Shat<strong>in</strong>, New Territories, Hong Kong.Contact Person: Ms. Sarah CHAN, Executive ManagerTel: (852) 2252 8425 Fax: (852) 2145 7489Email: sarahchan@cuhk.edu.hkUltronics Enterprise Limited Booth No: 23Address: Unit 612, 6/F., Tower 1, Harbour Centre,1 Hok Cheung Street, Hung Hom, Kowloon, Hong Kong.Contact Person: Ms. Rotem CHENG, Market<strong>in</strong>gTel: (852) 2765 1926 Fax: (852) 2764 5254Email: rotem.cheng@ultronics.com.hkVik<strong>in</strong>g Group (HK) Ltd. Booth No: 15Address: Room 1202, 12/F., Kwong K<strong>in</strong> Trade Centre,5 K<strong>in</strong> Fat Street, Tuen Mun, New Territories, Hong Kong.Contact Person: Mr. P. CHEUK, General ManagerTel:(852) 2395 6339 Fax: (852) 2441 7068Email: vghk@netvigator.com175HOSPITAL AUTHORITY CONVENTION 2013School of Public Health, Booth No: 26The University of Hong KongAddress: 5/F., 21 Sassoon Road, Pokfulam, Hong Kong.Contact Person: Dr. Janice JOHNSTON, Associate ProfessorTel: (852) 2819 9108 Fax: (852) 2855 9528Email: jjohnsto@hku.hkThe Government of the HKSAR Booth No: 34Electrical and Mechanical Services DepartmentAddress: HSD, 6/F., EMSD Headquarters, 3 Kai Sh<strong>in</strong>g Street,Kowloon Bay, Kowloon, Hong Kong.Contact Person: Mr. Kay WONG, E/H/KC/4Tel: (852) 3155 4008; (852) 9017 1547 Fax: (852) 2553 7887Email: kaywong@emsd.gov.hkThe Government of the HKSAR Booth No: 35Food and Health BureauResearch Fund SecretariatAddress: 9/F., Rumsey Street Multi-storey Carpark Build<strong>in</strong>g,2 Rumsey Street, Sheung Wan, Hong Kong.Contact Person: Ms. Gigi LEUNG, Secretariat Executive(Grant Management)Tel: (852) 3150 8961 Fax: (852) 3150 8993Email: rfs@fhb.gov.hk
176HOSPITAL AUTHORITY CONVENTION 2013SponsorsA. R. Medicom Inc (Asia) Ltd.Abbott NutritionAdvantech Automation Corp (HK) Ltd.AIA Company (Bermuda) LimitedAlcate-Lucent Ch<strong>in</strong>a LimitedANZ Bank<strong>in</strong>g Group LimitedArjoHuntleigh (Hong Kong) Ltd.Asia Insurance Co Ltd.Asia Pacific Cater<strong>in</strong>g Corp Ltd.Associated Medical Supplies Co Ltd.Astra Zeneca Hong Kong LimitedBank of Communications Co Ltd.Ch<strong>in</strong>a Road and Bridge CorporationCitibank (Hong Kong) LimitedDah Chong Hong Ltd.Draeger Medical Hong Kong Ltd.Electrical & Mechanical Services Department, HKSAR GovernmentEu Yan Sang (Hong Kong) Ltd.FIL Investment Management (HK) Ltd.GE HealthcareGet<strong>in</strong>ge International (Asia) LimitedGlaxoSmithKl<strong>in</strong>e LimitedGreat Eastern Healthcare LimitedHutchison Global CommunicationsInvesco Hong Kong Ltd.Janley LimitedJohnson & Johnson MedicalJust Med LimitedL C Surveyors LimitedManulife Asset Management (Asia)Maquet Hong Kong LimitedMerck Sharp & Dohme (Asia) Ltd.Microsoft HK LimitedMillion Tech Development Limited
Multiple Surveyors LimitedNovartis Pharmaceuticals (HK) Ltd.Olympus Hong Kong & Ch<strong>in</strong>a LimitedONKA (HK) Co Ltd.Pacific Medical Systems LimitedPfizer Corporation Hong Kong LimitedPIMCO Asia Ltd.Realty Cheng & Partners Construction Ltd.Sun Fook Kong Construction LimitedThe Bank of East AsiaThe Ch<strong>in</strong>ese University of Hong KongThe Northern Trust Company of Hong Kong LimitedThe University of Hong KongUltronics Enterprise LimitedVik<strong>in</strong>g Group (HK) Ltd.Wong & Ouyang (HK) Ltd.Woon Lee Construction Co Ltd.Sponsors177HOSPITAL AUTHORITY CONVENTION 2013
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