Authors (including presenting author) :
Yuen FC(1),Fung A(1),LAM KCH(2),Wong CW(2),Wong MY(1),Au WY(1),Chan MW(1), Yu KH(1),Mak PK(2),LEUNG YL(2),LEE OKA(2),NG LK(2),Yeung HY(1),
Cheng CH(1),Mok KC(1),Yeung SL(1),Chung WH(1)
Affiliation :
(1) Occupational Therapy Department, Ruttonjee and Tang Shiu Kin Hospital
(2) Nursing Department, Ruttonjee and Tang Shiu Kin Hospital
Introduction :
Occupational Therapy Department of Ruttonjee Hospital developed a new service model to enhance steady and timely provision of assistive devices (AD) to in-patients with close collaboration with Nursing Department. Link-OT is assigned in each ward being responsible for (i)a top-up system in wards to provide steady supply of selected AD (including pressure relief heel-protectors and protective hand-mittens); (ii) screening and following-up patients’ needs and (iii) collecting feedback from users. The AD are custom-made to ensure good quality and cost-effectiveness.
Objectives :
To enhance steady and timely provision of good quality assistive devices to in-patients and to increase service coverage and cost effectiveness.
Methodology :
1. Establish a working team with OT and nursing staff;
2. Design custom-made AD;
3. Arrange production logistics;
4. Set-up top-up system in wards;
5. Assign link-OT for each ward;
6. Develop work-flow for prescription and follow-up actions;
7. Start from August 2018 and cover all wards gradually;
8. Conduct user satisfaction survey in December 2019.
Result & Outcome :
The new service model improved service quality, service coverage, staff satisfaction and cost-effectiveness.
1. The provision of heel-protector and hand-mitten in wards increased 38% and 145% respectively from 2017 to 2019. During non-office-hour, the provision of heel-protectors increased from 7.4% (2018) to 50.6% (2019); hand-mitten from 25.4% (2018) to 68% (2019). Therefore, timely response could be achieved with the new service model. Among all wards, ICU had most significant increase in the AD utilization suggesting that critically ill patients demand provision of proper AD.
2. A 10-point scale satisfaction survey for users has been conducted. The survey focused on 3 areas including (i) Patient care with prompt OT follow-up; (ii) Facilitation for nursing management on pressure injury and physical restraint; (iii) Work-flow of AD prescription. The mean scores of the 3 areas were (i) 9.31/10; (ii) 9.31/10 and 9.41/10 respectively. The mean score of overall satisfaction level was 9.43/10 indicating service was very well recognized by ward staff. The satisfaction score and utilization rate from geriatric wards were the highest.
3. Through the communication loop between the link-OT and nursing staff, the design and production quality of AD were continuously improved to meet the patients’ needs.
4. The average cost of one AD is about $50. Comparing to the commercially available products with price range from $79 to $398, the production of our custom-made AD is cost-effective.