Authors (including presenting author) :
Mak HY(1), ChanWMM(1), TangMK(1), Yuen SK(6), Lo YF (8), Tsoi LL(2), Tse WM(5), Chen KK(3), Yik WM(7), Yeung TK(4), Ho KH(4), Tong KM(9), Lam PK(9), Chan TH(9), Chong YK(17), Li KY(10), Kong SK(11), Lai TW(12), Yeung KY(2), Chu MK (13), Cheung WS (14), Tsoi SC (15), Lau HY (16), Man HY(1), Leung HT(1), Chan WF(1), Leung KK(1)
Affiliation :
(1) Central Nursing Division, Princess Margaret Hospital, (2) Central Nursing Division, Caritas Medical Centre, (3) Central Nursing Division, North Lantau Hospital, (4) Central Nursing Division, Yan Chai Hospital, (5) Central Nursing Division, Kwai Chung Hospital, (6) Medicine & Geriatrics Department, Caritas Medical Centre, (7) Medicine & Geriatrics Department, Princess Margaret Hospital, (8) Central Sterile Supplies Department, Kowloon West Cluster, (9) Information Technology Division, (10) Community Nursing Service, Kowloon West Cluster, (11) Specialist Out-Patient Clinic, Princess Margaret Hospital, (12) Cluster Planning And Commissioning, Kowloon West Cluster, (13) Neurosurgery, Princess Margaret Hospital, (14) Infection Control Team, Princess Margaret Hospital, (15) Quality & Safety, Princess Margaret Hospital, (16) Family Medicine Clinic & Primary Healthcare, Kowloon West Cluster, (17) Pathology Department, Princess Margaret Hospital
Keyword 1: :
Inpatient Result Screening
Keyword 2: :
Digital Transformation
Introduction :
Despite the availability of a Clinical Management System in Hong Kong hospitals, the manual workflow in managing paper laboratory and radiology reports includes printed reports for doctor sign-off and handwritten notes for subsequent actions. This introduced inefficiencies, increased the risk of transcription errors, delayed treatment, and encroached on valuable clinical space. It is revealed that nurses spent 1–2 hours daily filing printed reports, reducing time for direct patient care. The success of the Electronic Result Screening (ERS) system in outpatient services since 2020 highlighted its potential for inpatient settings, where patient volume and multidisciplinary care demands are significantly higher. These findings underscored the need for a pilot project to evaluate ERS’s safety, effectiveness, and impact on workflow for inpatient wards.
Objectives :
The primary objective of the pilot project was to evaluate the safety, effectiveness, and workflow impact of the ERS system in inpatient settings across four Hong Kong hospitals. The aim was to eliminate the inefficiencies of paper-based result screening, reduce administrative burdens, and enhance communication among multidisciplinary teams. Additionally, it aimed to align with sustainable development goals (SDGs) by reducing paper waste and improving healthcare efficiency through digital transformation.
Methodology :
The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model guided the pilot’s implementation. The project involved nine pilot sites—five inpatient wards and four day wards—across four hospitals. ERS was integrated into the Clinical Management System (CMS), enabling electronic result screening, digital sign-off, and automated communication for closed-loop workflows. Training sessions were conducted for doctors and nurses to ensure familiarity with the system. Data collection included pre- and post-implementation measurements of safety, efficiency, and staff satisfaction. A customized questionnaire was distributed to capture staff feedback on usability, workflow alignment, and system integration. Operational data from the hospital’s IT system were used to evaluate time and paper savings. Post-implementation data were collected one month after the rollout to ensure adequate adaptation, with a focus on comparing outcomes between day wards and inpatient wards.
Result & Outcome :
Safety: Reduction in errors related to incorrect report filing and transcription. Efficiency: Time savings in filing and accessing reports, with a baseline of 1–2 hours per day spent on these tasks in inpatient wards. Effectiveness: Improved closed-loop communication, measured by staff feedback on enhanced team coordination. Satisfaction: Higher staff satisfaction in day wards, where simpler workflows better aligned with ERS, compared to mixed satisfaction in inpatient wards. Environmental Impact: Reduction in paper usage, with day wards reporting significant savings equivalent to one tree per month across four pilot sites. 1. Day Wards:
Day wards reported significantly higher satisfaction and system effectiveness compared to inpatient wards.
Safety: 91% of day ward staff rated ERS as reducing errors in report filing.
Efficiency: 64% of day ward staff reported time savings in managing reports, compared to only 30% in inpatient wards.
Effectiveness: Day wards demonstrated better alignment with ERS workflows, with 85% of staff positively rating closed-loop communication and 88% reporting user-friendliness. 2. Inpatient Wards:
Inpatient wards showed mixed outcomes, with only 55%–63% of staff positively rating communication, workflow facilitation, and user-friendliness.
Challenges included complexity in multidisciplinary coordination and misalignment with existing workflows, which affected overall satisfaction (55%).
3. Environmental Impact: Both day and inpatient wards reported reduced paper usage, with the highest savings observed in day wards due to streamlined processes.
