Hong Kong East Cluster (HKEC)
The Hong Kong East Cluster (HKEC) serves an estimated population of 0.83 million covering the Eastern and Wanchai districts of the Hong Kong Island as well as the Outlying Islands (excluding North Lantau).
It comprises six hospitals and 12 general out-patient clinics. The six hospitals are Pamela Youde Nethersole Eastern Hospital (PYNEH), Ruttonjee & Tang Shiu Kin Hospitals (RHTSK), Tung Wah Eastern Hospital, Wong Chuk Hang Hospital, Cheshire Home (Chung Hom Kok) and St. John Hospital. The general out-patient clinics include eight in urban areas and four on the outlying islands of Cheung Chau, Lamma and Peng Chau. The Cluster provides a full range of comprehensive in-patient, out-patient, ambulatory, Accident & Emergency, allied health and community-based healthcare services. In addition, the Hong Kong Tuberculosis, Chest & Heart Diseases Association supports the Cluster by promoting health education programmes for primary and secondary prevention.
Key Achievements
To cope with challenges from expanding prevalence and complexity of illnesses among elders, HKEC keeps strengthening services in pressure areas. PYNEH opened two additional beds in the Intensive Care Unit in October 2011. Extra quotas were offered for hospital-based haemodialysis. Automated peritoneal dialysis was developed for renal patients with indications. RHTSK strengthened palliative care services for terminally-ill patients through specialist out-patient clinics and home visits. With the increase in acute stroke cases, initiatives were phased in to implement new management protocols in PYNEH and to enhance treatment in RHTSK.
HKEC emphasised ambulatory and community care to reduce avoidable hospitalisation. Psychiatric services in community and primary care setting were greatly enhanced with a basket of programmes including appointment of case managers and establishment of a rapid crisis intervention team. Discharge planning teams of PYNEH and RHTSK and home support team operated by non-government organisations were commissioned in October 2011 under the integrated care model for high-risk elderly discharged from hospitals, to enhance early formulation of discharge care plans and post-discharge support.
HKEC has built a robust quality and safety system with continuous improvement. Re-use of class II critical single use devices was phased out ahead of target. On provision of cancer care, the Clinical Pharmacist Programme implemented since September 2011 has enhanced the safe use of chemotherapeutic agents at treatment sites; and more than 490 patients with breast or colorectal cancer benefitted under the integrated care of case managers. Patient safety culture was further reinforced through the Good Crew Resource Management (CRM) Practices in Action in March 2012. The annual cluster-wide Quality & Safety Seminar became a whole-day event for the first time in 2011-12 to satisfy colleagues’ desire for sharing knowledge and best practice.
Modernisation continued to keep pace with modern clinical practice to sustain service quality while keeping up with service growth in the Cluster. PYNEH set up a centre for autologous haemopoietic stem cell transplant in December 2011 and commenced Positron Emission Tomography / Computed Tomography service in March 2012.
Fostering People First culture is of paramount importance, especially amidst staff shortage and high turnover. Apart from human resource measures implemented to retain and motivate staff, HKEC improved work-life quality for frontline staff through ward renovation and modernisation as well as replacement of facilities and equipment in wards. Moreover, nurses were supported for Lean Management Training to improve patient flow and streamline work processes.
To maintain a healthier workforce, integrated occupational safety and health (OSH) awareness and improvement programme was implemented, resulting in continuous drop in the number of injury-on-duty cases. Furthermore, the HKEC OSH team was recognised as one of the HA Outstanding Teams in 2012, reflecting the Cluster’s achievements on its journey from safety to staff wellness.
To conclude, HKEC has practised strategic demand management with prudent expansion of service capacity with a strong patient safety culture while maintaining financial sustainability in 2011-12.