Authors (including presenting author) :
Ms. Wong TK (1), Mr. Kong CH (1),Mr. Kwong ST (1), Ms. Lo CW (1), Ms. Tsang PL(1), Ms. Cheng P(1) , Ms. Lam PL(1),
Mr. Law KH(2), Mr. Ho YK (2), Ms. Cheng KF(2) , Dr. Lui MS(2) ,Dr. Lam DCL(2)
Affiliation :
(1) Department of Physiotherapy, Queen Mary Hospital
(2) Department of Medicine, Queen Mary Hospital
Introduction :
A new program (Mobile Team for Assisted Ventilation in Medical Ward) with multidisciplinary team approach was implemented in Queen Mary Hospital (QMH) since September 2020 aiming at improving the standard of care for patients on both non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV).
Objectives :
To review the outcome of patients under the care of this new service model of Mobile Team in medical wards in QMH.
Methodology :
The multi-disciplinary team includes respiratory physicians, respiratory nurses and physiotherapists. Respiratory physicians would triage the patients into three clinical categories. Categories 1 and 2 refers to a better prognosis while Category 3 indicates a poor prognosis. The respiratory nurses would transfer skills in respiratory care to other colleagues in medical wards. Enhanced physiotherapy service including early mobilization and bronchial hygiene, was provided to Categories 1 and 2 patients to facilitate weaning and functional recovery. Average length of mechanical ventilation as well as hospital stay and mobility outcome were documented. Data from September to November 2020 were analyzed. Category 1 and 3 were excluded in the review due to very limited sample size and no enhanced physiotherapy service was provided respectively.
Result & Outcome :
Total 63 patients with mean age 76.9±16.1 were seen by mobile team during the study period. 52% could be weaned off from NIV/IMV within three days. Comparing the same month data in September 2018 (pre-program) and September 2020, the average length of stay was shortened from 4.6 days to 3.2 days and the mortality rates decreased from 25% to 13.6%. Moreover, 25 (39.6%) patients could be mobilized out of bed on day 2. Upon discharge, 23 patients could walk with assistance with a median improvement of one Modified Functional Ambulation Classification rank.
Conclusion:
The new multidisciplinary service program facilitates ventilator weaning and functional recovery in patients on mechanical ventilation. This initial experience provides ground for further running of this new service and evaluation of further cumulated experience.
