Authors (including presenting author) :
POON A (1), Liu CF(1), Law YY(1),Hui G(1), Wong KK (1)
Affiliation :
(1)Occupational Therapy Department United Christian Hospital
Introduction :
Face-to-face occupational therapy services undergoing challenging especially those on site community occupational therapy (COT) and geriatric day rehabilitation during the Coronavirus disease 2019 (COVID 19) epidemic. The challenges encountered during COVID 19 include referred COT case live in confirmed COVID 19 building and repeated service suspension of geriatric day hospital. An alternative service delivery model by tele-rehabilitation program for COT and geriatric day rehabilitation is needed to overcome these barriers and challenges. The tele-rehabilitation program was an interim measure to maintain service accessibility & continuity for indicated patient & care giver during epidemic.
Objectives :
The tele-rehabilitation program for COT and geriatric day rehabilitation was developed in 1st quarter of 2020, pilot trial in 2nd quarter of 2020 and fully implementation from 3rd quarter of 2020 which aimed at 1) empowering indicated patients and care-givers, 2) providing an interim & timely assessment & intervention in order to maintain service accessibility & continuity for indicted patient & care giver during epidemic.
Methodology :
The tele-rehabilitation program includes tele assessment and tele intervention through synchronous and asynchronous telecommunications include phone, smart phone, desktop and tablet with internet connection.
Tele assessment – consist of information gathering & Pre-COT assessment include environmental screening & home safety screening, availability of assistive devices and need identification for community support.
Tele intervention – consist of patient & care giver education and advice, home environmental adaptation and follow up on home safety, home based functional training and home program prescription and monitoring, assistive device prescription /follow up and prescription of HA Go (ABPS Activity Based Prescription System) and locally available multi-media education materials.
On-going program evaluation and monitoring was adopted include throughput data from CMS, types of delivered service and modes of delivered service.
Result & Outcome :
From May to November 2020, total 125 patients were selected to provide tele-rehabilitation program (106 was COT patient and 19 was geriatric day rehabilitation patient). Total 182 contact provided (125 and 57 was new contact and follow up respectively). Average 1.45 contact for each patient. Among delivered service type, 34.4% was environmental screening & home safety screening, 28.3% was patient & care giver education and advice, 24.8% was prescription of HA Go & home based functional training /home program prescription & monitoring and 12.5% was assistive device prescription /follow up. 89.6% was synchronous mode. 100% referred COT case was provided timely intervention and met performance batch. All patients and care givers expressed satisfaction with the quality of the program and had a positive perception of the program.
Conclusion: Tele-Rehabilitation Program for community occupational therapy and geriatric day rehabilitation offer an alternative service delivery model. This could improve access and continuity to community and rehabilitation services, prevent unnecessary delays in the receipt of care under an influence of the COVID 19 epidemic. Both the development of new applications as well as the use of existing readily available technologies have the potential to enhance the occupational therapy intervention and enable the convenience for occupational therapist to practice healthcare at a distance.
