Radiotherapy, commonly known as electrotherapy, is a method of cancer treatment using high-energy radiation, which can be used to treat different parts of the cancer in a precise and targeted manner according to the patient's physical condition. Radiation therapy must ensure that the high-energy radiation is precisely targeted to the location of the tumor, and the dose must be accurate to destroy the chromosomes in the cancer cells so that they cannot grow or even die. Oncologists, together with other professional teams, will formulate a personalized radiation treatment plan for each patient, with the participation of radiotherapists and medical physicists being essential to ensure that the patient receives the most effective and appropriate treatment. Dr. Wong Chi-sing, Head of Department of Clinical Oncology, Tuen Mun Hospital, said, “Compared with conventional surgical treatment, the effect of radiotherapy takes a longer time to be reflected. If the doctor decides after assessment that the patient is ready for radiotherapy, he will further decide which type of radiotherapy is most suitable for the patient.” According to Dr. Wong, patients generally do not have any noticeable sensation when they receive radiotherapy: “If we compare it to a similar situation, the X-rays of radiotherapy and the ultraviolet rays of the sun are both radioactive, and we only feel the heat when we are exposed to the sun, and similarly, during the treatment process, the patient will not feel any radioactivity entering into the body. The biggest challenge for patients is the side effects associated with radiation therapy. There are two main stages of side effects, including some inflammatory symptoms, such as transient redness and swelling of the skin, during radiotherapy, and the long-term effects on the body, which vary according to the location and dose of radiotherapy. Once the doctor has assessed the patient's suitability for radiotherapy, the radiotherapist will take over the arrangement of treatment for the patient. Radiation therapy involves the use of high-energy radiation to treat tumors precisely, while minimizing the effects on other normal organs and tissues. Therefore, the radiotherapist will first create a suitable mold for the patient to ensure that the radiotherapy treatment can be carried out in a way that stabilizes the patient's position and focuses the energy on treating the cancer cells while avoiding affecting other normal organs. In addition, the radiotherapist will arrange computerized tomography sketching for the patient to outline the three-dimensional position of the organs with the assistance of computer images, and then treat the tumor according to the dosage prescribed by the doctor. Apart from precise location, the dose of treatment also needs to be highly accurate, and medical physicists play a gatekeeper role. Radiation therapy is carried out using a “linear gas pedal”, which resembles a capsule, and medical physicists regularly measure the accuracy of the radiation delivered by the “linear gas pedal”.
Xuanxuan, who is about to be 5 months old, is held in his arms by his father, kicking up and down with his feet, holding his father's fingers tightly with his little hands; his sister Yueyue on the side is not shy in front of the media spotlight, and lively poses different "just now" "Shishi" - the two sisters and brothers are so restless that it is hard to imagine that their lives were hanging by a thread and they barely had a chance to catch a glimpse of the world. The mother, Ms. Ye, said: "When I was about 25 weeks pregnant, I suddenly had abdominal pain one night. After being admitted to the hospital for examination, the doctor said that I had regular contractions and there were signs of premature labor. As a result, I was given a lung-strengthening injection. About 10 hours later, I gave birth to my second baby. The doctor explained to me afterwards that pregnant women with a history of premature birth are more likely to have premature birth again. As a result, I was extra careful when I was pregnant with my second child, but I also had amniotic fluid at the early stage at 23 weeks. Fortunately, I and The husband was mentally prepared and was immediately admitted to the hospital. The medical team continued to monitor and provide medical support, and it was not until the 31st week that Xuanxuan was born.” Although he knew that another pregnancy would be a risk of premature birth, he saw that she was growing up healthily every month. It gave Ms. Ye the confidence to welcome new life again and grow up with Yueyue. She said: "Premature babies do not have no chance of survival. They also worked hard to survive in my belly." Fighting for little lives In order to save more little lives like Yueyue and Xuanxuan who are on the "edge of survival", Mary Situ Tianxin, associate consultant of the Department of Obstetrics and Gynecology of the hospital, and other colleagues in the Department of Obstetrics and Gynecology and Children and Adolescents Department established the "Care for Marginal Survival Newborns and Parents Team" three years ago to provide customized solutions for premature babies and their families who are only 23 to 25 weeks old. Appropriate treatment plan. Dr. Szeto said: "Extremely premature babies have immature organ development and are more likely to develop health and intellectual development problems after leaving the mother's body. Taking babies born at 23 weeks as an example, the survival rate according to the literature is only about 40%, which is one in every four people. However, if we help expectant mothers to delay labor as much as possible through prescription prenatal steroids (commonly known as "strong lung shots") to help lung function mature, magnesium sulfate to reduce the risk of cerebral palsy, and use of tocolytic drugs, etc. After a week or two, the baby's survival rate can increase to 60 to 70%. ” Extremely premature babies are born in the delivery room and then receive birth certificates. This requires close cooperation from an interdisciplinary team. The team will review the condition of the expectant mother together every week and help parents decide on the first aid plan for the baby’s birth based on clinical assessment. Huang Xiaozhen, Consultant of the Department of Pediatrics and Adolescents at Queen Mary Hospital, said: "Extremely premature babies are at a higher risk of developing serious complications due to their immature organs, which will affect their survival rate and future development. If parents decide to take active treatment, we will After successful first aid, the baby is sent to the neonatal intensive care unit, where instruments and drugs are used to assist breathing, intravenous nutrition is injected through a central catheter, prescribed anti-inflammatory drugs are prescribed, and the body temperature is monitored. Extremely premature babies are very fragile, and every medical step requires them. , the procedure is also very important, especially the first hour of clinical work must be done properly, otherwise the baby's growth and development will be very different in the future, which will affect his life, so it must be handled carefully. " The team has been serving in grief for two years. More than ten pairs of parents have successfully increased the average survival rate of 23-week-old babies from 27% to 50%. The results are encouraging. For parents who have unfortunately experienced the pain of miscarriage, the team not only provides palliative care, but also cares about the physical and mental needs of the parents. For example, parents are asked to make models of the hands and feet of the deceased baby as a memorial, and parents are encouraged to knit small quilts for their loved ones or write letters. Use the card to tell your baby what you want to say. Chen Xijiao, Operations Manager of the Obstetrics and Gynecology Department of Queen Mary Hospital, said: "Our role is to accompany parents to go through the pain of miscarriage. Many parents who choose palliative care for their babies will also ask me, 'Am I wrong? What? "As medical staff, we cannot make decisions for parents. The only thing we can do is to comfort them not to look back. The emotion of regret will only trap the parents in grief." Another team member, Senior Nursing Department of Queen Mary Hospital. Director Li Yunming said: "It is also very important for parents to be able to choose how to say goodbye to their children. Many parents feel very uncomfortable because they see their babies still struggling to survive before they die, but they are unable to do anything. We will help parents express their wishes , hoping to do something for the child at that moment, such as bathing him, holding him, or even changing his name and recording it on the birth certificate. I hope to help the family prove that this baby once existed in the world and try to keep it as long as possible. More traces of his life to heal the broken hearts of his parents.” The team won the Hospital Authority’s “Outstanding Team Award 2024.”
Uncle Liu, who is in his seventies, requires regular follow-up consultations in different specialties in public hospitals. Due to the limited annual leave of his children, he may not be able to do so every time.
Take time off to accompany the doctor. On this day, after he went to the ophthalmology clinic alone for a follow-up consultation, he walked out of the consultation room with a thick stack of paper in his hand.
open……
When he was confused, the nurse invited Uncle Liu to the "Comprehensive Patient Service Center" to provide him with consultation services for making an appointment. Nurse's discipline
I saw in the record that Uncle Liu had follow-up appointments in multiple specialties. In order to avoid the elderly having to go back and forth to the hospital multiple times, I asked him to make an appointment.
Go to the counter and ask the staff to sort out the follow-up time for him.
The counter staff checked Uncle Liu's follow-up consultation period in other specialties through the computer system and selected an outpatient appointment for him on the same day.
There is another follow-up date so that he does not have to spend an extra day back at the hospital. Since follow-up consultations can be concentrated on the same day,
It is also easy for Uncle Liu’s children to take time off to accompany doctors.
Flexible appointment arrangements and patient-centered services
The Hospital Authority (HA) implemented "Flexible Appointment Arrangement" in all specialist outpatient clinics at the end of June this year, and the appointment computer system has been
Through technological improvements, frontline staff can check patients' follow-up periods in different specialties at a glance. When the patient needs it
When making an appointment for the next follow-up consultation in a certain specialty, the staff can search for the follow-up appointments that the patient has made within the specified period, and the system can also
"Recommended reservation dates" and "Not recommended reservation dates" will be displayed.
"Recommended appointment date" means that the patient has other follow-up consultations at the same hospital on the same day; "Not recommended appointment date" means that the patient has other follow-up appointments at the same hospital on the same day
Need to go to other hospitals for treatment. The staff will select a date from the "Recommended Appointment Date" and then ask the patient for his or her wishes.
Please organize the most ideal follow-up time for them.
Dr. Li Liye, Chief Administrative Manager (Network Operations) of the Hospital Authority, said that the original intention of implementing "flexible appointment arrangements" was to improve
Patient’s consultation experience: “We understand that when patients have to go in and out of the hospital multiple times for follow-up consultations in different specialties, for some patients, especially the elderly,
It is undoubtedly a burden for patients and those with mobility impairments. Their caregivers also need to spend extra time with the patients. "Flexible Appointment"
"Scheduling" allows patients to "have choices". Whether it is a centralized follow-up visit on one day, or a few days apart, patients can choose independently. "
First trial run at Tseung Kwan O Hospital and positive response
In the past, if frontline staff wanted to centralize follow-up appointments for patients, they would need to check the patient's appointment records in different sections of the computer system, or
Relying on patients to remember their own follow-up time is a complicated process. Now you can check all records with one click, which is convenient for frontline workers
The staff immediately selects the most suitable follow-up time for the patient according to the situation.
The specialist outpatient clinic of Tseung Kwan O Hospital is the first public hospital to trial "flexible appointment arrangements". Since its implementation at the end of last year, it has been operating smoothly
In addition, it also received positive responses from frontline colleagues and patients, and the measure was expanded to all specialist outpatient clinics within a short period of time.
Xu Xiu-ming, deputy department operations manager of the Specialty Outpatient Department of Tseung Kwan O Hospital, said: "The measures are widely welcomed by patients and caregivers, who are very happy
This measure provides great convenience. On the one hand, it takes care of the patient’s medical needs, and on the other hand, it can also accommodate the caregiver’s schedule, especially
Working people. After helping patients unify the follow-up period, patients and caregivers feel that the service is considerate, and frontline colleagues can also improve patients'
Experience your contribution and increase your job satisfaction. The measures bring a win-win-win outcome for patients, carers and frontline colleagues. "
"Flexible Appointment Arrangement" is one of the HA's measures to promote a patient-centered clinical experience. In the future, the Hospital Authority will strive for excellence.
Continue to examine areas that can improve patient experience at different levels to ensure that patients’ needs can be taken care of in every possible way.