Professor Frances Kam-yuet Wong’s warm smile and friendliness were what first caught our attention. Bringing along some cinnamon tea she bought from the United States, she openly offered to make us tea, as she guided us through her life story of working beyond the call of her duty as a nursing profession. Charged with a passion to serve the community Prof Wong, President of the Hong Kong Academy of Nursing (HKAN), described her determination to embark on a journey to lobby for better patient care through advocating for policy changes and leading spear-headed changes to introduce multidisciplinary care into the Hong Kong community. Hers is a story that echoes her belief that the whole is greater than the sum of its parts.

The humanitarian aspect of medical care touched her heart. After graduation and assuming the role of a registered nurse, Prof Wong had a renewed sense to directly touch the lives of others. This motivated her to spend her weekends visiting refugee camps in Kowloon City. By helping in the clinics, she was able to provide valuable help that these clinics depended on by assisting in essential procedures that were in heavy demand. With a motivation to lend a helping hand wherever it was welcomed, she also regularly visited children with intellectual disabilities. Prof Wong recounts a particularly memorable time during her time as a young nurse when she was able to share a unique and deep bond with her long-term patients in the intensive care and renal wards. With in-depth conversations made with every decision, a naturally close rapport was built between them. She was deeply touched when she was invited to the funerals of her dear patients.

Unlike their medical counterparts, nursing specialists in Hong Kong previously did not have any registries or accreditation systems. That began to change in October 2011, when HKAN was established, with the aim to strive for regulation of advanced nursing practice and to accredit nurse specialists on par with international standards. Prof Wong played a pivotal role in the establishment of the HKAN, and her mission now is to achieve statutory status and gain legal protection for nurse specialists in Hong Kong so that the public is protected by safe professional practice. Prof Wong’s diverse background and extensive clinical experience guide her to lead the fight for the rights of nurses. Prof Wong is a key player in HKAN’s efforts to regulate advanced nursing practice. In large part as a result of her efforts, numerous nurses in mainland China have received an internationally recognised accreditation status, and it is hoped that this system can achieve statutory status in Hong Kong. This system would provide legal protection for specialist nurses and enhance healthcare services provided to the community by ensuring that safe, professional nursing care is provided to all patients. Not only does Prof Wong approach her daily work with an incredible amount of passion, she has also always taken the initiative to go the extra mile for example by working with the underprivileged on her days off during her time as a practising nurse, and more recently through lobbying and advocacy for policy changes that will improve patient care. Prof Wong serves as an exemplary model of how healthcare professionals should approach their work.

“Hong Kong has medical services but not healthcare services.” These words from an American professor gave Prof Wong pause for thought. During her research in transitional care from hospital to community, Prof Wong realised that the inadequacy of post-discharge community healthcare leads to high readmission rates and increases the burden of Hong Kong’s healthcare system. This led her to the idea of community-based health centres, which consist of interdisciplinary healthcare professionals such as nurses, physiotherapists, occupational therapists, and counsellors. Together, the team help to solve underlying social problems that contribute to health problems, so that the public can receive community-based support. The government-funded pioneer district health centre will be established in Kwai Tsing district, with hopes to enhance the public’s awareness of disease prevention and to provide support for the chronically ill. As a member of the Steering Committees on Primary Healthcare Development and Prevention and Control of Non-communicable Diseases, Prof Wong envisions the progressive participation of other districts and the involvement of the whole Hong Kong population. She hopes that ultimately, more and more citizens will take an active role to manage their own health instead of solely relying on healthcare professionals.

Prof Wong describes nursing as a calling, saying, “I did not choose nursing, but nursing chose me”. Since the early days of her career, when she decided to pursue nursing instead of a Sociology degree, Prof Wong has always found the job to be incredibly rewarding. She feels privileged to be trusted by patients and is grateful for the opportunity to accompany them on their journeys. This immense job satisfaction drives Prof Wong to further her career as a nurse, and also to advance the profession as a whole. Along the way, she has met many inspirational figures, whose passion for the profession and for the care of patients she greatly admires. They include professors who taught her in nursing school and numerous members of the HKAN.

To draw our interview to a conclusion, Prof Wong offered a few words of advice for both healthcare providers and the public. To healthcare professionals, she says, “Follow your passions, as this will be better for both yourself and your patients.” In general terms, she also advises everyone to, “Take more responsibility for your own health, and remember to practice self-care.”

Professor Chetwyn Chan is a pioneer in his field—one of the first to integrate academia with the community. Driven by his strong belief that academia should pivot on the wider community, his research efforts revamp the traditional concept of rehabilitation, firmly establishing rehabilitative community services as an integral component of modern healthcare.

A distinguished figure in the community, Prof Chan serves diversified leadership roles in both administration and academia. He is presently the Associate Vice President (Learning and Teaching), Chair Professor of Rehabilitation Sciences, and Director of the University Research Facility in Behavioral and Systems Neuroscience at The Hong Kong Polytechnic University (PolyU). Outside of his official duties, he is perhaps more well-recognised within the community as the Vice-Chairman of the Executive Committee of The Hong Kong Society for Rehabilitation (HKSR).

“I don’t believe academia is limited to only research,” Professor Chan asserts. “Academia must not neglect social needs.” It appears that few university graduates actively participate in Hong Kong society, and he considers this a pitfall of the tertiary education system. Unwilling to fall into this trap, he takes a further step, using PolyU as a cradle for knowledge transfer.

After 3 years of clinical practice as an occupational therapist, Professor Chan pursued a PhD in Educational Psychology. He then became a scholar and researcher at PolyU and invested his efforts in psychology and rehabilitation sciences. One of his main research areas is post-stroke rehabilitation; an interest driven by a vision of creating a paradigm shift in the community of stroke patients: from engaging in activities of daily living to autonomous and independent living.

“Things don’t happen easily with a mere desire to take an extra step”, Professor Chan concedes, “it is important to choose to do something that society truly needs and is willing to receive.” His interest in helping disabled individuals coincided with an unmet gap between post-stroke patients being discharged from hospital and their leading a meaningful and productive life. Rehabilitation services were often delayed, offered long after discharge from hospital, and the services themselves were limited to the bare essentials. Aside from the institutional shortcoming, there was a lack of patient awareness. Post-stroke patients seemed to be led to believe that the basic services provided by the Hospital Authority were adequate, and they were unaware of needs- and community-based rehabilitation services that are crucial to attain the goal of independent living. For instance, vocational rehabilitation is pivotal in enabling young post-stroke patients to regain a worker role in the family. Activity and participation have become the cornerstones of the contemporary rehabilitation recommended by the International Classification of Functioning, Disability and Health (ICF); however, the Hospital Authority and post-stroke patients appeared unmotivated to fund or purchase such services. There was a profound need to develop rehabilitation services in conjunction with official healthcare services.

The field of rehabilitation has evolved greatly over the past 30 years. In the past, it was little more than an afterthought. In an ageing population and with younger onset of some chronic illnesses, rehabilitation has developed into an integral part of the patient healthcare journey.

Current stroke rehabilitation services provided at the Hospital Authority focus on conventional skills training, helping patients regain their ability to perform activities of daily living through repeated practice. However, when patients are exposed to a different scenario in the community, it is difficult for them to turn their training into actual coping skills. To tackle this challenge, Professor Chan, with his doctoral students, constructed the first self-regulated learning protocol. The value of this protocol in helping post-stroke patients to regain lost daily activity skills has been validated in a series of randomised controlled trials. This day-to-day intervention protocol consists of a three-stage training programme based on cognitive neuroscience knowledge-task chunking, self-referenced appraisal, and mental rehearsal. Self-regulated learning allows patients to be more aware of their strengths (abilities) and weaknesses (disabilities), so they can address new scenarios through integration and synergy of skills they have learned or regained. This, as noted by Professor Chan, is a good demonstration of pushing the limit of the patients’ frontal cortex to produce the executive functions necessary for achieving independent living in the community.

Using his knowledge of self-regulated learning and the ICF model, Professor Chan established comprehensive rehabilitation services for post-stroke patients in the HKSR. Professor Chan found that this was as a great platform to bridge the divisions between academia and community, as well as his interests to find solutions for addressing patients’ needs in the community. The HKSR wholeheartedly embraces the mission of providing community-based rehabilitative services for patients with chronic diseases. Patients who have suffered from stroke are one of the core groups benefitting from its services. The new service focuses on the activity and participation needs of post-stroke patients and, in particular, their return to work and community living. With this service and the self-regulated learning strategy, post-stroke patients benefit from a greater capability to work and live independently, as well as contribute (rather than be a burden) to the well-being of their families and communities.

By taking many carefully considered extra steps, Professor Chan is transforming the post-stroke rehabilitation services that were once an afterthought into a full-fledged framework with holistic care. However, patient awareness of the new services is still lacking, and rehabilitation services remain disconnected from hospitals. Professor Chan continues to work hard, hoping to generate sufficient evidence and impact with the new services, so that the government will adopt the new service model into the health system. Professor Chan hopes, one day, to see hospital- and community-based rehabilitation services in parallel, as a cohesive whole.