Authors: (including presenting author): :
Wong WY(1), Chan KS(1), Sze SSP(1), Leung SY(2), Chan TM(3), Ng SCJ (1), Yip CW(1)
Affiliation: :
(1)Department of Medicine, (2) Department of Physiotherapy, (3) Department of Occupational Therapy, Haven of Hope Hospital
Introduction: :
The PR program of Haven of Hope Hospital was first pioneered in Hong Kong in 1991. It is important to review our service with the international standards in order to deliver high quality of care to our patients.
Objectives: :
To benchmark the service quality of pulmonary rehabilitation (PR) program with established overseas national quality indicators
Methodology: :
Literature search & review: relevant international documents are searched with the key words of rehabilitation AND quality indicator AND pulmonary rehabilitation. Out of the four relevant documents searched, two documents were adopted as international quality indicators for auditing criteria:
1. Quality Standards for Pulmonary Rehabilitation in Adult, British Thoracic Society (BTS) 2014
2. Quality indicators for Pulmonary Rehabilitation programs in Canada: A Canadian Thoracic Society expert working group report, 2019
Process of accreditation:
Two external auditors, one having experience in hospital accreditation and the other being a Respiratory Medicine specialist with experience in PR, were involved. Field visit and relevant document review were conducted by the auditors in the PR Center. Each standard of quality of program was scored as fulfilled / partially fulfilled / improvement required / not fulfilled.
Result & Outcome: :
Our PR program fulfilled 8 out of 10 BTS Quality Standards. Two areas required improvement. Firstly, 16.6% of our patients could not start PR program within one month of discharging from hospital due to transport issue. Secondly, there was no patient involvement in developing standard operating procedures. The program fulfilled 10 out of 14 Canadian Quality Standards. One area requiring improvement was that we had regular outcome audit but no documented recommendation and follow up plan. In addition, our program did not measure direct or indirect 1-Repetition Maximum test for strength assessment or exercise prescription as we used other equipment for strength training like resistance band and whole body vibration. Moreover, our PR program duration was 6 weeks instead of 8 weeks as suggested by Canadian group, though we fulfilled the recommendation by BTS group.
Conclusion:
This is the first reported PR program accreditation in Hong Kong and most of the international Quality Standards are fulfilled. However, not all Quality Standards recommended are applicable to local setting. So locally derived quality standards that align with the international standards is recommended for maintaining a high standard of care.
