Authors (including presenting author) :
Ng YT (1), Chan YS (1), Ruth Lau KY (1), Yeung YC (1), Yik WM (1), Mak KM (1)
Affiliation :
(1) Department of Medicine and Geriatrics, Princess Margaret Hospital
Keyword 3: :
Assisted Ventilation
Introduction :
The use of non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV) in general medical wards has been increasing, leading to a higher care burden for nursing staff. The MOVE Service for the General Medical Wards with a multidisciplinary team (MDT) approach has been implemented at Princess Margaret Hospital since October 2020, aiming at improving the standard of care for patients receiving both NIV and IMV and to optimize weaning support across medical wards. The MDT comprises respiratory physicians, respiratory nurses, and physiotherapists.
Objectives :
1. Enhance the standard of care for patients receiving both NIV and IMV by transferring respiratory care skills to colleagues in general medical wards.
2. Optimize general wards capacity by reducing the median length of stay.
3. Establish treatment goals in alignment with the parent team, family, and patients.
Methodology :
The MOVE Service conducted daily visits after respiratory nurse prepared the patient list. Respiratory physicians triaged patients into three clinical categories: Categories 1 and 2 indicate a better prognosis, while Category 3 signifies a poor prognosis. Regular follow-up reviews are subsequently provided, and weekly case conference is arranged. Suitable cases would be selected to Respiratory enhanced bed. Respiratory nurses transferred skills in respiratory care—including airway management, ventilator troubleshooting, and alarm settings—to the parent medical teams, which comprised doctors, nurses, and allied health professionals. Respiratory physicians optimize the parameter settings of NIV and IMV. Treatment goals are established in alignment with the parent team, family, and patients regarding weaning and the ceiling of care. Enhanced physiotherapy services, including early mobilization and bronchial hygiene, are provided to Category 1 and 2 patients to facilitate weaning and promote functional recovery.
Result & Outcome :
A total of 416 patients were seen by the Mobile Team in 2025, exceeding the annual caseload target of 400. Of these, 295 patients were on NIV, while 121 patients were on IMV. The median length of stay for patients receiving NIV decreased significantly in the MOVE Service, dropping to 14 days compared to 23 days reported in the HA survey conducted in 2017. Patients who received IMV had a median length of stay of 16 days, representing a substantial reduction from 54 days in 2017 (Figure 1). For NIV, the weaning success rate in 2025 increases from 78% to 80%. For IMV, the weaning success rate in 2025 decreases from 69% to 60%, as 59% of IMV cases belong to Category 3, which indicates a poor prognosis (Figure 2). Conclusion:
The Ventilator Mobile Team Service can enhance the standard of care for patients receiving both NIV and IMV through streamlined communication among the MDT. The
ward capacity can be optimized by reducing the median length of stay.
