Authors (including presenting author) :
Tse CP, Chan KW, Tsang WY, Tsai MT, Yu CKE, Cheung YP, Choi KL, Chan TJ
Affiliation :
Department of Orthopaedics & Traumatology, Prince of Wales Hospital
Introduction :
Hallux valgus reconstruction includes osteotomy, soft tissue and tendon correction. In the past, the average length of stay (LOS) was around 4 days. However, there is an unceasing increased demand on hospital beds, the early discharge would facilitate the bed utilization and improve access block. Thus, a well-organized multidisciplinary care model was established to provide pre-operative preparation for patient underwent hallux valgus reconstruction surgery in the Orthopaedics Ambulatory Care Centre (OACC). It is aimed to improve the quality of patient care and maximize the resources so as to achieve a better patient outcome.
Objectives :
(1) To provide multidisciplinary service for patients undergoing hallux valgus reconstruction surgery at day care setting through one-stop approach
(2) To reduce unnecessary hospitalization and to shorten the LOS
Methodology :
An integrated care model was designed for patients undergoing hallux valgus reconstruction surgery. The process included pre-operative assessment by orthopaedic surgeon and anaesthetist, splintage fitting by Prosthetic and Orthotic therapist, and perioperative management education by nurse. Patients were well-prepared for same day discharge or early discharge after the operation. An early follow-up in 1-week time would be arranged for post-operative wound assessment and alignment checking in the Nurse Clinic. Appointment would be arranged for subsequent follow-up by orthopaedic surgeon. Patient satisfaction survey was conducted.
Result & Outcome :
From January to December 2019, 53 patients were recruited into this service model in OACC. Sixty-six percent of patients were followed up in Nurse Clinic for early post-operative care. Thirty-four percent of the patient who was classified as a complicated case would be followed up by the surgeon. Forty-three percent of patients could be discharged on the same day of surgery, 31% of patients required 2 days hospitalization, and there was only 26% of patients stayed for 3 days or above. Through this enhancement program, a total of 68 in-patient bed days were reduced. All patients were satisfied with the service provided. Conclusion: Integrated care model for patient underwent hallux valgus reconstruction surgery in OACC shows a positive outcome on the reduction of LOS and improve patient’s satisfaction.
