Authors (including presenting author) :
Cheung PCT(1), Suen MYA(1), Lee LYL(2), Chan LCJ(3), Mak MYM(4)
Affiliation :
(1)Department of Physiotherapy, Tin Shui Wai Hospital, (2) Department of Accident & Emergency, Tin Shui Wai Hospital, (3) Department of Physiotherapy, Pok Oi Hospital, (4) Department of Physiotherapy, Tuen Mun Hospital
Introduction :
Public healthcare system has been facing a great challenge on coping the increasing demand in Accident & Emergency Department (AED) and in-patient beds. As the gate keeper, it is important to have early and effective intervention in AED and minimize unnecessary admission for better demand management. This study is to review the role of early physiotherapy service in AED of Tin Shui Wai Hospital (TSWH) in pain management, facilitating safe discharge, minimizing admission and hence better inpatient resource utilization.
Objectives :
(1) to provide early on-site physiotherapy consultation for quality of service enhancement; (2) to facilitate the discharge planning through early physiotherapy intervention; (3) to minimize hospital admissions.
Methodology :
Patients who had received on-site physiotherapy service (including physical examination, pain management, mobility training and education) at AED of TSWH from 15th March 2017 to 19th December 2019 were recruited for data analysis. Outcome measures included: (1) Numerical Pain Rating Scale (NPRS); (2) discharge destination; and (3) patient satisfaction level. Paired t-test was used to analyze the data.
Result & Outcome :
From 15th March 2017 to 19th December 2019, 1370 patients (574 male and 796 female; mean age of 54.4+/-17.31years old) attended AED and received on-site physiotherapy service. 63.5% of patients had chief complaint of spinal pain and the others had chief complaint of peripheral pain. NPRS was significantly decreased from 6.78 to 4.57 (p< 0.05) after on-site physiotherapy service. With significant reduction in pain level, 92% of patients was discharged without admission. Their mobility was improved from 39.1% assisted walker (MFAC I to IV) before treatment to 9.5% assisted walker after physiotherapy treatment. Moreover, patients satisfied with the service with mean satisfaction level of 5.08 out of 6.
On-site physiotherapy service in AED was effective in reducing pain level, facilitating safe discharge and minimizing unnecessary hospital admission with good patient satisfaction.
