Authors (including presenting author) :
NG TW(1), TSE KC (2), IP SW(1), SO YC(1), WU WC(1), CHEUNG WM(1)
Affiliation :
(1) Quality and Safety Office, Kowloon East Cluster (KEC) (2) KEC Basic Skills Simulation Training Centre
Keyword 1: :
Junior doctors
Keyword 2: :
patient safety
Keyword 3: :
clinical incidents
Keyword 4: :
high-risk invasive procedures
Keyword 5: :
simulation training
Keyword 6: :
Advance Incident Reporting System (AIRS)
Introduction :
Clinical procedural competence in high-risk invasive procedures such as central venous catheter (CVC) insertion, chest drain insertion, advanced airway management with tracheostomy emergencies are crucial for junior doctors. Insufficient training in these procedures may lead to clinical incidents. The strategy for preventing clinical incident is enhancing junior doctors’ knowledge, skills, and awareness of patient safety. Basic Skills Simulation Training workshops and Quality and Safety (Q&S) Whatsapp Intern group were established to teach techniques for high-risk invasive procedures and disseminate clinical safety tips message respectively to minimize clinical incidents.
Objectives :
1) Provide structured simulation training on high-risk invasive procedures to junior doctors. 2) Increase awareness of patient safety when performing high- risk invasive procedures. 3) Minimize clinical incidents involving junior doctors in KEC hospitals.
Methodology :
Creating a learning environment at KEC Basic Skills Simulation Training Centre with classroom learning and hands-on practice of invasive, high-risk procedures such as CVC and chest drain insertion, advanced airway management and tracheostomy emergencies. Junior doctors developed proficiency in skills, awareness of patient safety and speak up culture. Adherence to Procedure Safety Checklist, emphasis on key safety aspects such as prevention of guidewire retention are also included. Reminders are sent regularly at Q&S Whatsapp Intern group which provides a communication platform for Interns to receive quality and safety risk alerts. Reporting of related clinical incidents is monitored via Advance Incident Reporting System (AIRS).
Result & Outcome :
From 2022 to 2025, a total of 12 classes comprising 252 hours training were completed, with 159 junior doctors participated. According to course evaluation, 90.6% of participants reported techniques enhancement. 94.6% of participants were satisfied with course curriculum. Data from AIRS between 2021 and 2025 showed significant decrease in KEC clinical incidents involving junior doctors since project implemented. Incidents of CVC guidewire retention decreased from 1 case in 2021 to 0 case from 2022 to 2025; wrong side of chest drain insertion incidents declined from 2 cases in 2024 to 0 case in 2025. No clinical incidents related to airway management or tracheotomy intubation were reported from 2021 to 2025. In conclusion, Basic Skills Simulation Training workshops and Q&S Whatsapp Intern group are useful strategies to enhance knowledge, skills and safety awareness of junior doctors and minimize clinical incidents.
