Authors: (including presenting author): :
Lee KC (1), Leung HW (1), Kong WC (1), Lau YM (1), Lam ML (1), Chiang CY (1), Cheung CW (1), Chan MF (2), Leung KC (2), Lee K (2), Chow MK (2)
Affiliation: :
(1)Department of Old Age Psychiatry, Castle Peak Hospital (2)Information Technology Section, New Territories West Cluster
Keyword 1: :
Electronic booking system
Keyword 2: :
Appointment scheduling optimization
Keyword 3: :
Geriatric mental health services
Keyword 4: :
Healthcare workflow efficiency
Keyword 5: :
Quality improvement
Keyword 6: :
Patient safety
Introduction: :
Mental health services for elderly patients are critical amid Hong Kong's ageing population. The Psychogeriatric Specialist Outpatient Clinic (PGSOPC) at Tuen Mun Mental Health Centre (TMMHC) serves vulnerable elderly patients with complex psychogeriatric conditions. The legacy paper-based booking system created challenges: transcription errors, untracked priority waiting times, manual triage calculations, and no statistical reporting. These led to booking errors, prolonged waits, staff frustration, and compromised care. This quality improvement project developed a digital e-booking system integrated with the OPAS to enhance patient outcomes and operational efficiency.
Objectives: :
Primary Objectives: Reduce booking/data entry errors via automated validation Reduce data retrieval/appointment handling time via single-platform access Enable automated data capture for statistical analysis Shorten patient waiting time for psychiatric assessment Secondary Objectives: Improve staff confidence/reduce stress Enhance accuracy via electronic triage with auto-scoring Strengthen safety by ensuring complete information capture Support evidence-based improvement
Methodology: :
Study Design: Quality Improvement project using Plan-Do-Check-Act (PDCA) cycle Setting: PGSOPC, TMMHC, CPH, NTWC Key System Features Implemented: Electronic Patient Data Validation: Automated real-time retrieval of patient demographics (HKID, name, DOB, sex, address) from OPAS with duplicate entry prevention, eliminating manual re-entry and reducing transcription errors. Electronic Triage Form: Digital version of the standardized 8-item PGSOPC New Case Triage Form (maximum 21 points) with automated scoring algorithm and triage category classification (P1: ≥9 points; P2: 6-8 points; Routine ≤5 points). Generation of PDF files/ printouts with specialist screening fields and electronic signatures. Automated Appointment Scheduling: Intelligence-based slot matching algorithm that: • Filters sessions by service type • Prioritizes slots by triage category • Displays real-time vacancy status with session codes • Auto-generates bilingual appointment slips Statistical Reporting Module: Real-time dashboard that: • Records new referral numbers and triage category distribution • Displays referral-to-appointment time by triage category • Summarises patient demographics (age, sex, referral source) • Analyses clinic utilization patterns by service type and attendance rates • Generates reports for quality improvement Measurements: • Quantitative: Appointment handling time, patient waiting times, staff confidence /stress (5-point Likert), booking error, data accuracy, transcription error, triage scoring /category classification error • Qualitative: Staff focus groups, workflow observations, user experience interviews
Result & Outcome: :
i. Quantitative Outcomes: • Appointment handling time: 30 → 20 minutes (33% reduction) • Patient waiting time: 20 → 12 minutes (40% reduction) • Booking error: None • Staff confidence: 3.1/5 → 4.2/5 (35% improvement) • Staff stress: 3.9/5 → 2.1/5 (46% reduction) • Data accuracy: 100% • Transcription error: None • Triage scoring /category classification error: None ii. Qualitative Outcomes: • Reduction of staff frustration and increase in job satisfaction • Increase in confidence in data accuracy and integrity • Elimination of duplicate data entry and paper record management • Eradication of triage categorization error through automated algorithm iii. Programme Scalability & Blueprint Development: This project establishes a scalable blueprint for digital transformation across psychiatric services. The system has commenced pilot implementation at General Adult Psychiatric Specialist Clinic, TMMHC, validating transferability beyond old age psychiatry and potential for Hospital Authority-wide rollout.
