Authors: (including presenting author): :
Chau KH, Chu HL, Cheng YC, Fung YS, Lam CM
Affiliation: :
Occupational Therapy Department, Tuen Mun Hospital
Keyword 1: :
Service efficiency
Keyword 2: :
Workflow enhancement
Introduction: :
With the previous workflow in Tuen Mun Hospital Occupational Therapy Outpatient Department, all new and follow-up patients had to queue at reception for registration and then wait for PCA to perform case intake and health screening questionnaires. This created congestion at the entrance, overwhelming of clerical staff with multiple tasks (queue management, identity/payment verification and enquiries), inadequacy of PCA support in the treatment area and prolonged patient waiting time. There were occasions when patients were confused about the procedures and idled outside department for long time. An enhancement in workflow was required to address the issues.
Objectives: :
(1) To reduce patients’ waiting time in registration, health checking of vital sign screening, and proceeding to functional limb training (2) To enhance the overall workflow efficiency and patients’ understanding when attending OPD training sessions
Methodology: :
A pre-test-post-test design was used. 4M1E (Man, Machine, Material, Method, Environment) framework was applied for root cause analysis and improvement work was performed accordingly. The enhancements included staff training on case handling, refinement of patient registration procedures, application of self-administered screening questionnaires and blood pressure monitor, introduction of signage for patient notice, and incorporation of CQMS system. The new workflow has been implemented since January 2025. The satisfaction level of staff (PCA, clerk and OT) and patients that had experienced both the new and old workflow were gathered by online questionnaire (0-10 Likert scale) in February 2025. Workflow efficiency was measured. For patients, the time reduced to proceed to remedial activities was measured. For PCA, the time reduced in handling each new case and measuring blood pressure for each case were measured. For clerk, the time reduced for instructing each new case and distributing remedial sheets for old case were measured.
Result & Outcome: :
Responses were collected from 53 patients and 11 staff (6 PCAs, 2 clerks and 3 OTs). From patients’ perspectives, the mean satisfaction level of the old and new workflow was 7.92 and 9.57 respectively, showing an increase of 20.7% (p < 0.05). In particular, the satisfaction level on instruction clarity was increased significantly (pre: 8.32; post 9.03; +8.60%; p< 0.05). Moreover, patients’ mean satisfaction level on the waiting time was gathered. The new workflow was considered more time-saving (pre: 6.32 post: 9.00; +42.40%; p< 0.05). Direct measurement of patients’ waiting time in queueing at reception and taking blood pressure under the new workflow was taken. There was a reduction of 1 minute and 50 seconds for each patient on average. Patients’ mean satisfaction level on PCA availability in treatment area also improved (pre: 7.36; post: 8.77; +19.20%; p< 0.05). From staff perspective, there was an increase in mean satisfaction level of operation under the new workflow (pre: 4.45; post: 8.27; +85.70%; p< 0.05). In particular, the mean satisfaction level in time required in handling new cases was significantly increased (pre: 2.72; post: 8.00; +193%; p< 0.05). The new workflow was considered more efficient in reducing patients’ waiting time for taking blood pressure (pre: 1.36; post: 8.45; +520%; p< 0.05). Direct measurement reflected that the time reduced in handling each new case and taking blood pressure for each patient by PCA was 2 minutes and 50 seconds on average. The time reduced by clerk in handling each new case was 40 seconds on average. The mean satisfaction level of PCA availability in treatment area also increased significantly (pre: 1.45; post: 4.90; +237.50%; p< 0.05). This innovative initiative significantly enhanced clinical service by optimizing patient workflow, which in turn improved patient satisfaction and increased efficiency in service delivery. By streamlining processes, patients could receive timely care, thereby elevating the overall quality of the clinical services.
