Authors (including presenting author) :
Kwok WH (1), Chiu TC (1), Wong KY (1), Wong CK (1), Kong CY (1), Cheng HC (1)
Affiliation :
(1) Department of Orthopedics & Traumatology UCH
Introduction :
For the increasing aging and more complexity of orthopedics disease, UCH Orthopedics Department are facing two major challenges (1) High occupancy rate due to increasing aging population. (2) Long patients’ length of stay (LOS) due to lack of systematic discharge planning and continuity of care. This proposal aims to establish the role and functions of Discharge Coordinator. The orthopedic patients will be transferred to rehabilitation bed and discharge to home timely with a better discharge plan given.
Objectives :
(1) To decrease Orthopedics patient LOS and unplanned readmission rate. (2) To enhance patient / caregiver empowerment upon discharge.
Methodology :
[Case recruitment] The project will be divided to two phases. In the Phase 1 (Nov 2019 to Feb 2020) patients with lower limbs fracture and fracture hip case in rehabilitation ward will be recruited. Patients with low back pain will be recruited additionally in the Phase 2. [Role & responsibility of Discharge Coordinator] The Discharge Coordinator will follow the patient journey from admission, through six perspectives 1. Perform a comprehensive social and health assessment 2. Formulate individual discharge plan 3. Collaborate with multidisciplinary team 4. Provide health education to patients/caregivers 5. Provide phone hotline for discharged patient 6. Enhance the capability of case nurse to manage patient discharge. [Outcome measurement] It was categorized as: (1) Patients’ length of stay (2) Unplanned readmission (< 28 days) rate of target patients (3) Ward nurse’s satisfaction survey towards this program.
Result & Outcome :
[Results] Project will be started from Nov 2019. (1) From Feb 2020 (started Phase2) to Jun 2020, there were 633 cases recruited in this program. The three highest number of cases (low back, fracture patella and pelvis) will be selected for LOS evaluation. Their average LOS were decreased from 10.5 days to 9.55 days (9.05%) when compared with Feb 2019 to Jun 2019 data. (2) After half year evaluation, the over 80% of O&T ward nurses showed positive feedback of the new service model. [Conclusion] In the long run, the expected outcomes of this Discharge Coordinator Program will be effective in lowering Orthopedics patients’ LOS and improve workflow on patients discharge.
