Authors: (including presenting author): :
Ng PYT(1), Lui CT(1), Tsang LS(1), Wu YH(2), Wong SH(2), Lau WH(3), Wong LL(3), Yip KS(4), Leung KC(4)
Affiliation: :
(1)AED TMH (2)AED POH (3)AED TSH (4)NTWC IT Department
Keyword 1: :
AED Patient flow
Keyword 2: :
Digital monitor
Keyword 3: :
Smart Hospital
Introduction: :
The patient input, throughput and output of ED patients varies widely on a day to day and hour to hour basis. Bottlenecks in patients awaiting consultation, investigations or other procedures can be difficult to monitor, and crowding may be difficult to identify in a timely manner in the busy ED environment. A real-time, automated, comprehensive ED monitor providing detailed information has been long overdue. The recent digital transformation of logistic and workflow data in all AEDs in HA allows for a one-stop solution that can monitor patient flow, identify outliers, and initiate alerts for follow up actions.
Objectives: :
To develop and implement a comprehensive monitoring and alert system with customizable alarm thresholds and escalation criteria with a closed feedback loop using work phones, for senior medical and nursing staff to 1) monitor the situation in ED in near real time and distribute resources to bottlenecks, and 2) identify outliers and special cases for review.
Methodology: :
PulseGuard was designed and developed by the NTWC team. It can be accessed from computer workstations in the AED and is accessible to both nursing and medical staff. PulseGuard utilizes a simple, intuitive design and rides on integration with eAED databases to count the number of patients meeting customizable criteria, (e.g., awaiting triage, awaiting doctor consultation). The results are displayed using a 2-tiered colour format with customizable thresholds, to reflect the real-time patient flow in the AED. Once alarm thresholds are triggered, automated and customizable HA Chat messages will be sent to predefined recipients for closed-loop communication and acknowledgement, followed with defined follow-up action. One time, recurring or escalating alerts ensure the feedback loop is closed.
Result & Outcome: :
ED PulseGuard was piloted in TMH in May 2025 and rolled out to POH and TSH. The interface was intuitive and minimal user training was required. The Cat-3 KPI performance in NTWC from 7-12/2025 was 92% after PulseGuard was rolled out, compared to 89.2% in the same period in 2024. PulseGuard also initiated an average of 6 alerts per day for patients with delayed ECG interpretation or prolonged idle time, highlighting its role in covering logistic loopholes in the busy ED environment. ED PulseGuard is scalable and sustainable for deployment in other hospitals in the HA. It has potential for even more additional features, and several enhancements, including a workflow for Medical Admission screening, agentic AI to identify cases at risk for deterioration, and personalized Dashboards for monitoring personal productivity, are already being planned as part of the Smart Hospital direction.
