Authors (including presenting author) :
Yuen S(1), Chung T(1), Chan N(1), Ip B(1), Chan C(1), Kwong S(1), Mok KL(2), Chung TS(2), Kan PG(2)
Affiliation :
(1) Physiotherapy Department, Ruttonjee & Tang Shiu Kin Hospitals
(2) Accident and Emergency Department, Ruttonjee & Tang Shiu Kin Hospitals
Introduction :
Physiotherapy (PT) service in Accident & Emergency Department (AED) in RTSKH included one-stop walking aids prescription and training. To further enhancing safe discharge, PT service on fall risk assessment and uncomplicated musculoskeletal (MSK) conditions were introduced in August 2019 with 60 minutes agreed responding time.
Objectives :
-To evaluate the PT service provision
-To evaluate clinical outcome and stakeholders’ feedback on service implementation
Methodology :
Individuals with AED triage category 3 or 4 without red flags referred for PT from August 2019 to December 2020 were included. Patient’s demographics, treatment outcomes and feedback from stakeholders were collected for evaluation.
Result & Outcome :
Results:
45 patients were referred. 67% of patients (n=30, mean age 65.5+/-20.9) with MSK conditions referred for pain relief. Upon discharge, pain was reduced from 6.3+/-2.1 to 4.4+/-2.1 (p< 0.05) in Numerical Pain Rating Scale (NPRS) and mobility was improved from average 5.0 (supervised walker) to 6.1 (indoor independent walker) in Modified Functional Ambulatory Category (MFAC).
33% of patients (n=15, mean age 82.1+/-9.5) were referred for fall risk assessment. Their average number of fall in one year was 1.2 (fall in current admission excluded) and 47% of them (n=7) was found to have high fall risk by assessment using Screening Form on Fall Risk for Older People in the Community (FROP-Com Screen). Walking aids prescription with gait training & fall prevention advice were given.
All patients were stratified for further medical care upon discharge. 24% of patients could be discharged with self-empowerment without follow-up. 27% were referred to Geriatric Day Hospital and 44% referred for further management in PT outpatient department.
80% of patients were seen within 60 minutes upon receiving AED PT referral. 80% of AED doctors and nurses (n=22) agreed that enhanced PT service was effective and could assist AED in discharge planning and arrangement of community service support.
Conclusions:
The one-stop enhanced PT service in AED is effective to improve patient care and support safe discharge. Though imposing challenges on PT in response time, it provided prompt and integrated care for patients to cater their immediate & preventive needs. Further collaboration with Department of Geriatrics on Geriatric AED Front Door Program will be enhanced in the coming future.
