Expanded observation wards to reduce number admitted The Hospital Authority will expand observation wards in all accident and emergency departments in an effort to ease admission rates to hard-pressed public hospitals. The scheme, which will cover all 14 public hospitals, follows similar changes two years ago at Queen Elizabeth Hospital and Tuen Mun Hospital. The scale of the expansion would depend on the space available and policies at individual hospitals, said Ho Hiu-fai, who heads the authority's co-ordination committee for accident and emergency departments. Dr Ho said the expansion would reduce ward admissions, with patients initially being kept under observation rather than being sent straight to a ward. A review of the expansion at Queen Elizabeth and Tuen Mun hospitals had shown a reduction in admissions from the accident and emergency departments. Dr Ho, also chief of accident and emergency services at Queen Elizabeth, said admissions had dropped from 150 to 125 patients a day. 'Many of these patients were admitted to the internal medicine wards, the busiest in the hospital,' he said. 'The drop will free one fourth of the internal medicine ward, which is quite an obvious fall.' Dr Ho said the role of emergency rooms had gradually changed from only providing first aid to serving a 'gate-keeping function' for the admission of urgent patients. 'The role of the emergency ward has not been emphasised but we think it is now getting more crucial for us,' he said. 'The future of accident and emergency departments in terms of resources and energy will be pointed in this direction.' He said Hong Kong was following an international trend in expanding emergency ward services. It was already common practice in Britain, the United States and Australia. Queen Elizabeth, Tuen Mun and United Christian Hospital in East Kowloon had the busiest emergency rooms, each with 30 beds. The most common complaints of people attending accident and emergency departments are recurring chest pains, headaches, back pain and head injuries. Dr Ho said the emergency ward at Queen Elizabeth was similar to that of a normal ward but with a different set of guidelines. It offers blood tests, CAT scans and physical therapy. Doctors from the internal medicine department make daily visits to the ward, where patients spend an average of 12 hours under observation. The triage section assesses the urgency of treatment, ranging from critical and emergency to urgent, semi-urgent and non-urgent. Most emergency ward attendances are classed as urgent. Dr Ho said modern medical technology meant many emergency cases could be handled at public and private clinics. Hong Kong has a total of 263 emergency ward beds.