Authors (including presenting author) :
MOK QWW (1), LUK OTY (1), KWONG SFS (2), WAN SY (2), WONG MMS (3), WONG MMY (3), CHEUNG KYH (3)
Affiliation :
(1)Physiotherapy, Allied Health Clinic, Family Medicine and Primary Health Care Department, HKEC,(2) Physiotherapy Department, HKEC, (3)Family Medicine and Primary Health Care Department, HKEC
Introduction :
Physiotherapy Shoulder Program in Family Medicine and Primary Health Care of HKEC has mission of promulgating patients’ self-management to tackle the third most common musculoskeletal disorders referred for Physiotherapy. Escalating waiting time for this Program posed additional challenge to sustain this mission timely and effectively. “Conventional-Model Shoulder Program (CM)” was re-structured with “New-Model Shoulder Program (NM)” in April 2019 to alleviate the surging demand and boost patients’ self-management.
Objectives :
1. To reduce the waiting time for Physiotherapy Shoulder Program 2. To evaluate the effectiveness of the “New-Model Shoulder Program” 3. To further empower patients’ self-management and promote physiotherapists work efficiency.
Methodology :
“New-Model Shoulder Program (NM)” cultivated patients on self-management of shoulder disorders from first Physiotherapy intervention. After screening with questionnaire and assessment, Physiotherapists led and fostered self-management relating to daily functional activities (e.g. home-based therapeutic exercise, posture and functional ergonomics) through interactive group education. Patients would have first “Individual Physiotherapy Consultation Session (INDIVIDUAL)" follow-up in 4 weeks. For patients age > 70 or had special needs, only “INDIVIDUAL” would be arranged. Patients were reinforced to practise with the education materials daily and in follow-up “INDIVIDUAL”. Those required intensive Physiotherapy were referred to Out-patient Physiotherapy for secondary care. Clinical outcomes for patients discharged from the “CM” in 10/2018-3/2019 were analyzed retrospectively and compared with those from “NM” in 4/2019 to 9/2019.
Result & Outcome :
There were 221 patients attended the “CM” and 265 patients attended “NM” (age range 32-91). After “NM” implementation, waiting time for patients accessed first “Individual Physiotherapy Consultation Session” decreased from 20.4 to 12.7 weeks (p=0.000; for age >70: 10.9 weeks). Clinical outcomes of patients age < 70 (mean age 58.7+/- 8.8) in “CM” (n= 113) and “NM” (n=191) were evaluated. Mean duration of individual intervention dropped from 13.4 to 8.7 weeks (p=0.01). Patients completed both “CM” and “NM” improved in Numeric Pain Rating Scale mean from 5.0+/-2.5 to 1.5+/-1.9 (p=0.000) and Quick Dash disability score (QD in %) from 45.6+/-23.4 to 14.5+/-10.9 (p=0.002). No incident of adverse effect was reported. Patients from “NM” showed superior self-management as reflected from better QD (10.0 % p=0.000), Posture Awareness (p=0.000), Exercise Compliance and Active Approach on disease management.In conclusion, timely boosting patients’ self-management speeded up Physiotherapy service accessibility, enhanced physiotherapy effectiveness and workflow efficiency, and consolidated the mission of patient empowerment.
