Authors: (including presenting author): :
Lui CT(1), Lai YM(2), Leung KY(2), Chan YC(2), Ng PYT(2), Tse PY(2), Chan YW(1), Tsang MY(2), Mok CT(3), Yip Ricky(3), Leung KCC(3), Lo CKE(3), Lam PKJ(4)
Affiliation: :
(1)Accident and Emergency Department, NTWC, (2)Accident and Emergency Department, Tuen Mun Hospital, (3)Information and Technology Section, NTWC, (4) Quality and Safety Division, NTWC
Keyword 1: :
smart initiatives
Keyword 2: :
Patient Safety
Keyword 3: :
Operational Efficiency
Introduction: :
Emergency departments face ongoing challenges in ensuring patient safety and operational efficiency due to high patient volumes and complex workflows. Traditional monitoring methods frequently result in delays in identifying service bottlenecks, prolonged waiting times, and inefficient resource allocation. TMH AED introduced "The Safety Triad", a combination of three smart initiatives—ED PulseGuard, Special & Observation Cases in AED (SOCA), and Remote Patient Physiological and Location Monitoring (R-PALM). This combination enhances oversight, early intervention, and patient safety with a proactive clinical environment.
Objectives: :
(1) To deploy digital tools for real-time monitoring of patient journeys and early identification of service delays; (2) To improve patient safety, shorter waiting times, and optimize resource utilization.
Methodology: :
ED PulseGuard launched in June 2025, provides a digital visualization dashboard that tracks 20 aspects of the patient journey and delivers closed-loop notifications to doctors and nurses in-charge via HA Chat regarding extended waits for consultation, investigations, interventions, and admissions. SOCA launched in September 2025, provides an automated web-based dashboard for nursing observation, handovers, and continuous patient journey monitoring. R-PALM launched in mid-November 2025, utilizes wrist-band based wearable to monitor vital signs, ECG rhythm and location for patients with risk of unexpected deterioration, incorporating alarms and geofencing. Nurses monitor cases and record responses via mobile app on hospital phones, dashboard in nurse stations, and web portals. These three initiatives form The Safety Triad with integrated data for macro and micro patient monitoring. Standards are defined on workflows, patient scopes, role and responsibility to respond, escalate and address patients’ needs when there are alerts from the automated systems. Series of audits had been conducted to ensure compliance.
Result & Outcome: :
By December 2025, ED PulseGuard had sent over 7,900 notifications, supporting timely identification of bottlenecks and resource adjustments. SOCA had monitored over 20,000 patients, averaging 35 cases per shift. R-PALM has been applied over 460 times, monitoring more than 10 patients per day. The Safety Triad supports improvements in patient safety and operational efficiency within the ED through integrated real-time monitoring. The triad provides benefits beyond those achieved by individual initiatives. This approach aligns with connected journey of smart hospital development and offers potential for broader implementation in other AEDs or healthcare facilities to reduce delays and maintain care standards.
