Authors (including presenting author) :
Wong WM(1), Soong KH(1), Cheng MY(2)
Affiliation :
(1)Department of Orthopaedic Rehabilitation Unit, Tai Po Hospital.
(2)Department of Orthopaedic & Traumatology, Alice Ho Mui Ling Nethersole Hospital and Tai Po Hospital.
Introduction :
Geriatric hip fracture often results in disability and reduced quality of life. Generally, rehabilitation of patients with fracture hip are a very complex procedure which involve multidisciplinary input. By the virtue of 24 hours responsibility for patient care, nurses assume the role of coordinator of patient care along the rehabilitation process. The geriatric hip fracture and ostroporosis cases will be triple in the coming 30 years and the increasing trend is the reason of establishing this program. Besides, multidisciplinary care to the fracture hip patient is essential for better rehabilitation outcome.
Objectives :
1. To provide seamless rehabilitation for hip fracture patients.
2. To optimize patient’s functional independence.
3. To collaborate with multi-disciplines to tackle patient’s discharge barriers.
4. To shorten patient’s length of stay.
5. To enhance integration of patients into the community.
Methodology :
The Orthopaedic Rehabilitation Team at Tai Po Hospital advocates a collaborative and integrated care model for orthopaedic rehabilitation patients. All patient admitted to our hospital and suffered from hip fracture and aged 60 or above are recruited. The main features of rehabilitation care for geriatric hip fracture patients are as follows. Firstly, starting from October 2017, the implementation of 365-day physiotherapy for patients with geriatric hip fracture improves patient’s functional mobility and self-care ability. Secondly, starting from October 2017, the Ortho-Geriatric Co-Care Model provides regular geriatric case rounds for patients which help to stabilize their medical conditions. Thirdly, since January 2018, the Medico-Social Collaboration Program (MSC) provides community or respite service to patients with hip fracture once they are discharged from hospital.
Result & Outcome :
This collaborative service facilitates timely discharge of patients from hospital to community. In our department, the target length of stay for geriatric hip patient is expected 21 days. Under the Medical Social Collaboration(MSC) program, over 75% of geriatric hip fracture patients can be discharged less than 21 days, while before the MSC program only 50% of geriatric hip fracture patients can be discharged before the targeted length of stay. The lenght of stay for the geriatric hip fracture patient is much shortened.
