Authors (including presenting author) :
Chan YM(2),Tang YK(1),Koljonen P(1),Wong YW(1),Ng HK(3),Lau YP(4),Lee FL(3),Yeung CP(4),Wong CKC(2),Fong YK(2),Pang PY(2),Tsang CCR(2),Wan K(3), ELC Lo(4)
Affiliation :
(1)QMH,Orthopaedic and Traumatology Department(O&T) (2)MMRC,Physiotherapy Department, (3)MMRC,Occupational Therapy Department, (4)MMRC,Nursing Unit(NU).
Introduction :
The Maclehose Medical Rehabilitation Centre(MMRC)Jockey Club Specialist Out-Patient Clinic(SOPD) was open in May 2019.One Stop Back and Neck Clinic started service in July 2019.It provided comprehensive assessment and treatment by nurse,occupational therapist(OT),physiotherapist(PT) and orthopaedic doctor.
Objectives :
(1)Prompt multidisciplinary assessment and treatment for the newly referred O&T patients; (2)Multidisciplinary input for patients who need further rehabilitation or suitable for direct discharge. (3)Investigate the outcomes in function and patient satisfaction.
Methodology :
New patients of O&T SOPD were seen at One Stop Back and Neck Clinic at MMRC.Comprehensive assessment by nurse, OT, PT and orthopaedic doctor were provided.Immediate pain relief modalities, postural correction techniques,ergonomic advice and home exercise program were provided by PT and OT.Doctor made final decision of the plan and prescribed appropriate investigation and medication.Patients who needed further therapies were recruited to MMRC Back and Neck Pain Program(BPP),Day Therapy at MMRC or referred out.Patients who would not need further orthopaedic intervention were discharged with home program. Functional scores including Rolland Morris Disability Questionnaire(RMDQ),Neck Disability Index(NDI), Owestry Disability Index(ODI), QuickDASH and work roles were assessed.Patient Satisfaction Survey was also done.Phone call re-assessment was made to the discharged patients after one month.
Result & Outcome :
A total of 12 clinics,84 patients(39Male and 45Female, mean age 59.58)attended from 26th July,2019 to 1st November,2019.Most patients have back pain(60.71%),22.62%has both back and neck pain, and 16.67%has neck pain.67.14% of back patients scored below12/24RMDQ.81.82% of neck patients scored below40%NDI.46% of the patients has current job,20% were housewife and33% were retired. Average ODI and QuickDASH(neck patients)score presented were 31.6% and 27.5%. After team assessment,17 patients were recruited to BPP.2 were arranged day therapy at MMRC.32 patients were referred to other out-patient Physiotherapy Department.28 patients(33.33%)were arranged further follow up at O&T SOPD.56 patients(66.67%)were discharged with home program. Phone calls were made to the no follow-up back(39patients, 86.67%)and neck(19patients, 76%) patients.The average improvement after completion of prescribed home program was 4/24in RMDQ(p< 0.001)and 18.42%in NDI(p< 0.001).Average numeric global rating of change scale(NGRCS) was 5.28/10.The 30-day revisit rate was 0%. 100%patients were satisfied with the service in the survey, and 70% graded it excellent. Conclusion: This new service model allowed prompt multidisciplinary assessment and treatment for the newly referred O&T patients and facilitated direct discharge.Most patients were mildly limited in function. 66.67% of new back and neck patients were successfully discharged from O&T SOPD,with high patient satisfaction and significantly improved functional outcomes by home program and education. The revisit rate was also very low.
