Building an engaging team: an experience for the newly formed nursing team in Accident & Emergency (A&E) Department in Tin Shui Wai Hospital (TSWH) in Hong Kong.

Mr Heyman Tang1, Ms Angela WONG1, Ms Wai Ling Chan1, Ms Wan Man Lam1, Ms  Chiu Ying Chan1, Ms Mei Mei Chan1, Ms  Elaine Wong1, Ms Ka Po Ng1
1Accident & Emergency Department, Tin Shui Wai Hospital, Hospital Authority, , Hong Kong

TSWH commenced 8 hour A&E service on 15 March 2017.  It serves around 300,000 populations in TSW district. A new nursing team has been forming and going through different stages with different challenges.


  • To execute staff engagement activities
  • To maintain staff retention

Methods: Deming Cycle (PDSA)
Plan: Staff- mix analysis (in A&E experience) : novice (<1 year: 10%), junior (1-3 years: 24%), senior (> 3 years: 66%, in which 4-10 years: 19% and > 10 yrs 47 %). Daily attendance (12 hrs): 233 in average, max: 293. Around 30 cases of admission (17%) daily: Escort cases: nurses: 543 (0-9 cases daily); Staff came from different departments with different background.  Overwhelming figures lead to stress.
Do: Developed programs to engage staff e.g. coaching system, preceptor-ship program; Pilot training program (every nurse as speaker so as to achieve “they teach & they learn”)
Study: Assessed the effectiveness and injected new initiatives for the pilot and trials.
Act :

  • Engaged all nurses to divide 6 teams to manage 30 Subcommittees / task force groups e.g. infection control, Fall prevention & drug safety etc.  Encouraged to implement improvement projects to increase sense of belonging and self-actualization.
  • Regular meetings to review manpower to cater high attendance and high Inter-hospital Transport (IFT) cases.
  • Encouraged to participate staff engagement programs in community e.g. CPR training to secondary school students and health care staff in Mainland China and Community CPR Marathon so as to enhance staff’s self-esteem and self-actualization.
  • Further data collection by observation, interview and staff coaching survey.

Results: 55% (nurses) expressed stressful i.e. rating 1-5 (high stress level 1 to 10 low stress level).  However, 77% expressed “very happy” at work i.e. rating 8-9 (unhappy 1 to 10 very happy) and 18% rated 10.  95% of staff expressed they were “fully engaged”.  No staff resignation since service commencement.
Conclusion: A good leader is essential to build an engaging team.  Steve Jobs stated that “The only way to do great work is to love what you do”.  In turns, the only way to build great team is to love your team.

Ms. Angela Wong is an Emergency Specialty Nurse and works as an Advanced Practice Nurse in Accident and Emergency Department (AED) of Tin Shui Wai Hospital (TSWH) of New Territories West Cluster (NTWC) in Hong Kong. She graduated from the School of Nursing of the Hong Kong Polytechnic University in 2006. She also completed the Master of Science in Cardiology awarded by the Chinese University of Hong Kong in 2013. She worked in AED of Tuen Mun Hospital (TMH) of NTWC from 2006 – 2017. She participated in the commission of the opening of service of AED of TSWH – a newly established AED in NTWC of Hong Kong since 2017. She is the Training and Development (T&D) Coordinator in the department. She helps to deal with T&D related issues and implement relevant enhancement work e.g. coordinating department nurse training days, promoting Continuous Quality Improvement (CQI) programs, carrying out audits etc. She is also the vice-chairperson of Medication Safety Subcommittee in the department and helps to promote the culture of medication safety.