Authors (including presenting author) :
HUNG YW(1), WONG SF(1), LAM PL(1), LEUNG MK(1), CHAN PY(1)
Affiliation :
(1)Community Nursing Service, Our Lady of Maryknoll Hospital
Keyword 1: :
Smart Digital Transformation
Keyword 2: :
Clinical Accuracy
Keyword 3: :
Occupational Safety
Keyword 4: :
Data Security
Keyword 5: :
Real-Time locating
Keyword 6: :
Community Nursing
Introduction :
Community Nursing Services (CNS) encounter complex challenges when addressing multifaceted patient needs and navigating unpredictable environments during home visits. The lack of a real-time verification system towards staff location, coupled with inconsistencies between scheduled itineraries and actual visit sequences, creates dual risks in operational efficiency and staff’s safety. Besides, seamless access to the Clinical Management System (CMS) was hindered by reliance on paper-based documentation, leading to delays in clinical decision-making or risk in clinical errors. Additionally, patient data privacy represented a key vulnerability, as transporting physical records during home visits created opportunities for unauthorized access or loss. Furthermore, redundant administrative tasks, such as double-entry or delayed documentation, increased workload and reduced accuracy. This project addressed these gaps by integrating mobile technology into CNS’s practices.
Objectives :
(1)Enhance Operational Efficiency: Implement real-time "Time-In/Time-Out" inputs in CMS Home Care Record, monitoring staff locations/progress during home visits, ensuring Occupational Safety & Health (OSH) compliance, facilitating proactive incident response and manpower allocation (2)Enhance Clinical Accuracy: Promote clinical data-driven and patient-safe practices by eliminating paper-based errors via on-the-spot CMS access, improving clinical risk reduction (3)Enhance Data Security: Migrate to use password-protected/time-out screened iPads to review digital records, minimizing privacy risks associated with physical documents (4)Enhance Workflow Optimization Facilitates direct and instant CMS documentation during home visits, reducing administrative burdens of duplicate entry and advancing paperless workflows
Methodology :
(Phase 1)Technology Infrastructure Enhancement - iPads Upgrade: Functional diagnostics of all existing iPads; Transitioned from Citrix Secure Access to auto-VPN connectivity; Updated cellular data support/Performed iOS system and Apps updates (Phase 2)Workflow Optimization - Process Reengineering: Redesigned CNS routines and workflows; Conducted small-group staff training; Pilot testing of real-time "Time-In & Time-Out" inputs in CMS Home Care Record; Joint-visit skill-coaching (Phase 3)Full Implementation - System-Wide Rollout: Training seminar; Expanded real-time "Time-In & Time-Out" inputs in CMS Home Care Record to all CNS teams (Phase 4) Specialized Training - Competency Development: Promoted instant documentation in Electronic Injection Record and Wound and Packing Modules; Established regular/surprise compliance check and proactive alert for entry delays (Phase 5) Project evaluation - Quality Assurance Measures: Maintained ongoing compliance audits
Result & Outcome :
The project employed a multi-phase, technology-driven approach from Feb 2024 to Mar 2025. (A)Training seminar evaluations: 93.3% participant satisfaction with both content and delivery quality;93.4% reported enhanced understanding of new CNS workflow; 93.3% acquired practical mobile technology troubleshooting skills;93.4% demonstrated increased confidence in using on-the-spot CMS access by iPads during home visits. (B)OSH Compliance and Staff Adoption: ~90% adherence to real-time visit logging (C)Clinical Efficiency and Accuracy: ~70% reduction in essential physical records previously transported during home visit (D)Data Integrity: zero report in data breach (E) The transition to paperless documentation reduced Kardex-related administrative tasks by ~60% per patient case (i.e., Discontinued the use of “Nursing assessment form”, “Patient/Carer Empowerment Score” and “Progress note” in paper form). Saved >13700 sheets of paper each year.
