Authors (including presenting author) :
Tong YC (1), Lau SF (2), Kwan SMV (2), Cheung KL (2), Luk W (2)
Affiliation :
(1)Occupational Therapy Department, (2)Department of Family Medicine and Primary Health Care, Kowloon West Cluster
Introduction :
The average number of occupational injuries was thirty-six thousand per year in the past five years (Occupational Safety and Health Statistics Bulletin, August2019). Early assessment and intervention are essential for patients with injury on duty (IOD) to resume job and productivity in the society. A new Early-return-to-work (ERTW) program was established in West Kowloon General Out-patient Clinic (WKGOPC) in Oct 2017 and a multidisciplinary team was designated to cater for the management of IOD patients attending GOPCs in Sham Shui Po district.
Objectives :
To provide timely and appropriate multidisciplinary management to IOD patients to facilitate early recovery and resumption of job. To provide early education on IOD, Ordinary Assessment Board (OAB) and job plan; vocational counselling and self-pain management; and work hardening. To streamline and coordinate the referral to Allied Health (AH) services, specialty clinic, Work retraining services and OAB.
Methodology :
Patients within 3 months from injury on duty were referred for fast-track OT screening in GOPC. They were then triaged to ERTW program according to their motivation and compliance of initial self-pain management. Two designated doctors followed up patients with bi-weekly consultation sessions, closely monitored patients’ conditions, and coordinated necessary referrals for AH/specialty services and OAB. Early OT was started in GOPC on a weekly basis to facilitate early education on IOD, self-pain management, vocational counseling for building appropriate work habit, job plan and attitude.
Result & Outcome :
114 patients completed ERTW program from Oct 2017 to Dec 2020. Mean age was 50.8 (ranged 20-69, SD=11; Female: 62.3%). The commonest areas of injury were lower back (35%) and lower limbs (included knee and ankle) (32%). The mean access time to first OT assessment from IOD was significantly shortened when comparing to that prior to this program (31 days versus 180 days, P< 0.001). 81 patients completed the program and the average number of doctor consultation sessions was 8.9 (SD=5.1). With close monitoring on patients’ conditions reaching Maximal Medical Improvement, referral rate for OAB reached 75.3% by the end of ERTW program. Timely referral to specialty clinics (8.6% for Orthopedics, 88% for SOPD OT work hardening), Work Retraining Services (37%) were facilitated according to patients’ needs. The total rate of job resumption was 59.3% upon completion of OAB or the end of ERTW program.