Authors: (including presenting author): :
Pun MK(1), Chung SP(1), Chong HM(2), Wong LS(3), Wan WK (3), Sung MS (3), Ng YK (3), To YP (4), Li YH (4), Yim PK (5), Tse MT (5), Chan WF (5)
Affiliation: :
(1)Nursing Services Division, Tuen Mun Hospital (2)Department of Surgery, Tuen Mun hospital (3)Department of General Adult Psychiatry, Castle Peak Hospital (4)Department of Old Age Psychiatry, Castle Peak Hospital (5)Siu Lam Hospital
Keyword 1: :
Psychiatric wound care
Keyword 2: :
Telehealth consultation
Keyword 3: :
virtual wound assessment
Keyword 5: :
Multidisciplinary collaboration
Introduction: :
Psychiatric patients face heightened risks of skin injuries, which worsen psychological distress and infection susceptibility. In New Territories West Cluster (NTWC) psychiatric facilities, on-site wound specialist support is scarce. Previously, complex or infected wounds required referrals to the NTWC Wound Care Team for outpatient appointments, necessitating accompaniment by two mental health staff. This strained understaffed units and often induced patient anxiety.
Objectives: :
To mitigate these issues, the NTWC Wound Care Team collaborated with Castle Peak Hospital (CPH) and Siu Lam Hospital (SLH) to launch the Integrative Telehealth and Ambulatory Wound Care Service in March 2025. Core goals include: improving timely wound assessment via digital tools; enhancing care continuity through multidisciplinary collaboration; reducing patients’ physical and psychological burdens; and lowering healthcare utilization and associated costs.
Methodology: :
Following the Plan-Do-Check-Act (PDCA) cycle: Plan (P) – Established a protocol-based clinical pathway and a 3-tier care system (ward nurses, 7 wound resource persons, cluster wound care nurses), with streamlined referrals via GCRS. Do (D) – Ward nurses uploaded clinical photos to CMS; resource persons shared expertise. Referrals initiated teleconsultations (phone, photo, video) and on-site visits (within 1-2 days) for urgent needs like debridement. Check (C) – Average wait time for initial assessments dropped from 5.3 days (2024) to 0.9 days post-launch. Act (A) – Formalized the 3-tier system and telehealth protocols as NTWC psychiatric standards; refined digital tools/training, planned service expansion to other facilities, and continued outcome monitoring.
Result & Outcome: :
From March to December 2025, the service rolled out across CPH (22 wards) and SLH (11 wards). A total of 166 service episodes were delivered, comprising 161 telehealth consultations and 5 on-site services. These included 39 new consultations and 127 wound reviews, focusing on pressure injuries, traumatic injuries, and other wound types. The average waiting time for the specialist wound care service decreased 83.0%. The average healing time for non-chronic wounds was 2.5 weeks. Mental health nurses reported high satisfaction, such as reduced travel risks and clear guidance; patients valued avoiding long waits. The service proved cost-effective, though the virtual assessment faced limitations in diagnostic reliability. Despite virtual assessment limitations, the service is cost-effective, improves healing outcomes, and provides a vital alternative for psychiatric patients.
