Authors (including presenting author) :
Yip HT (1),Ng CM (1),Lam PL (1),Cheng P (1),Tsang TC (2),Leung SC (2), Tsui SH (2),Chu KL (2),Fung YF (3),Koljonen PA (3),Wong YW (3)
Affiliation :
(1) Physiotherapy Department, Queen Mary Hospital (2) Department of Accident and Emergency, Queen Mary Hospital (3) Department of Orthopaedics and Traumatology, Queen Mary Hospital
Introduction :
Traditionally, patients with acute low back pain (LBP) who require further in-patient rehabilitation have to admit to orthopaedic ward in acute hospital before transferring to rehabilitation hospital. In Queen Mary Hospital (QMH), a new direct admission program has been developed to reduce admission to acute orthopaedic ward, hence lessen burden of acute hospital. After multi-disciplinary assessment by doctor, physiotherapist and nurse in QMH EMW, suitable patients are directly transferred to MacLehose Medical Rehabilitation Centre (MMRC) to join the Neck and Back Pain Program for further in-patient rehabilitation. Physiotherapists in QMH play a significant role in formulating rehabilitation plan for LBP patients, this include assessing and providing timely pain relief intervention and ambulatory training at acute stage. In addition, stratifications are made to identify suitable patients for further rehabilitation in MMRC.
Objectives :
To review the direct admission program of LBP patients from QMH EMW to MMRC with screening by physiotherapist
Methodology :
The program has been commenced since May 2017. Physiotherapist screened all patients in EMW Patients with LBP during weekdays. Stratification were made according to the following criteria: pain level (Numeric Pain Rating Scale NPRS≥5), mobility level (Modified Functional Ambulation Classification MFAC≤ IV) and patient requiring multi-disciplinary pain management. Physiotherapist would then make suggestion to doctors for suitability of patient to join the program. Patients with LBP and directly transferred to MMRC from 1st May 2017 to 30th April 2020 were reviewed.
Result & Outcome :
During the review period, 610 patients with LBP were assessed and treated by physiotherapist at EMW. 191 patients (82 males and 109 females) with average age 55 were suggested for directly admission to MMRC from EMW QMH by physiotherapists. 35% of patients were suffered from back injury and 65% of patients had spontaneous or gradual onset of LBP. Before transferring to MMRC, the mean NPRS was 5.7 and the median MFAC was IV. No patient was transferred back to QMH during their stay in MMRC. All of them were directly discharged from MMRC. In conclusion, the program was safe and workable. It contributed to lessen the burden of acute hospital by reduction of admission of LBP patients to acute orthopaedic wards.
