EDTU PEG Insertion Workflow
Care Process & Redesign
Yishun Health One Improvement Festival
National Healthcare Group
8 April 2025
The aim is to align the EDTU PEG protocol with Onward 2026 objectives such as 'Assign Patients Into Care Stream', 'Quality &. The EDTU PEG protocol effectively reduces hospital stay duration and improves patient satisfaction by providing a streamlined care.
Year Submitted: 2025
Published Date: 08 April 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Cost Saving
About this Content
Aims
The aim is to align the EDTU PEG protocol with Onward 2026 objectives such as 'Assign Patients Into Care Stream', 'Quality & Patient Safety', and 'Operational Resilience'. Additionally, it aims to shorten the patient's stay in the hospital by eliminating the need for ward admission, thus delivering cost-effective care, convenience, and medical benefits to patients.
Background
The protocol was implemented to address the management of A&E patients with PEG complications, reduce ward admission rates, and decrease patients' overall length of stay. Previously, patients with PEG complications were admitted to the ward for 1-2 days, which increased the risk of nosocomial infections and reduced patient satisfaction.
Methods
Patients are placed onto a protocolised care stream to reduce ward admissions and allocate resources correctly. The General Surgery (GS) team reviews if patients are suitable for PEG reinsertion in the intended PEG change centre (Endoscopy Centre/Operation Theatre (OT)/Interventional Radiology (IR)). The procedure is carried out if suitable, and patients are discharged after successful PEG tube change.
Results
Since the implementation of the protocol in 2022, there has been a 15% reduction in inpatient admission rates, with 83.4% of patients with PEG complications discharged from EDTU since 2023. A total of 70 bed days have been saved, and there has been a rise in patient satisfaction due to earlier discharge and decreased re-attendance rates.
Conclusion
The EDTU PEG protocol effectively reduces hospital stay duration and improves patient satisfaction by providing a streamlined care process for patients with PEG complications.
Lessons Learnt
The protocol has demonstrated the importance of standardising care for patients with PEG complications and has shown that aligning with strategic objectives can lead to significant improvements in patient outcomes and operational efficiency.
Additional Information
The protocol's results are based on pre-protocol data (2020-2022) and post-protocol data (March 2023-2024). A total of 10 out of 12 patients were successfully discharged from the EDTU PEG protocol, with 2 patients admitted to the ward.
Keywords
EDTU, PEG, Protocol, Workflow, Cost-Effective, Patient Safety
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Emergency Medicine, Gastroenterology |
Project Lead(s) | Ng J.H., Swarup S. |
Project Member(s) | Rachel Yek |
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KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg