Authors (including presenting author) :
Leung ZCW(1), Chan ACM(1), Chan DWL(1), Wong GCK(2)
Affiliation :
(1)Physiotherapy Department, (2)Accident and Emergency Department, Queen Elizabeth Hospital
Introduction :
The number of attendances in Accident and Emergency Department (AED) was around 2 million annually in the last decade. Access block to hospital services during surge seasons poses a big challenge to our health care system. Physiotherapy (PT) service in the AED of the Queen Elizabeth Hospital (QEH) has been launched since 2002. Physiotherapists provide prompt on-site assessment and treatment to those indicated patients attending AED. This 365-day PT service aims to reduce avoidable hospital admission by formulating the most effective treatment plan that allows the patient to be discharged home safely. For those patients who cannot be discharged from AED on the same day, in-patient physiotherapy will also be continued for those admitted in Emergency Medicine (EM) ward. Fast-track out-patient or domiciliary PT service will be arranged to those indicated patients upon discharge. Physiotherapist contributes an important gate-keeping role in the AED by minimizing sufferings of the patients, enhancing patient satisfaction, and reducing the waiting time to access healthcare services. With the effective symptom-focused management, comprehensive discharge planning and follow up arrangement, patients can be discharged quickly, safely and comfortably to community and the AED re-attendance can also be reduced.
Objectives :
The aim of this study was to evaluate the effectiveness of the gate keeping function of PT service in AED.
Methodology :
This was a retrospective study. Patients referred for PT from AED from January 2015 to December 2018 were reviewed. On-site PT assessment and interventions including manual therapy, pain-relieving modality, education on self-management, mobility training and walking aids prescription were offered. Functional performance and pain intensity were reassessed after PT treatments in order to provide suggestions on discharge planning. The outcome measures to evaluate the effectiveness of AED PT service including percentage of patient discharged from AED after PT treatment, AED re-attendance rate within 28 days for those patients discharged from AED after PT.
Result & Outcome :
A total of 7297 patients were referred for PT from the AED in QEH during the review period. 37% of the patients were male while 63% of them were female. Majority of the cases referred for PT were frail elderly patients showing a decline in function. 70% of the referred patients were successfully discharged from the AED on the same day after PT interventions. 34% of the referred patients had been arranged fast track out-patient PT at Kowloon Central Cluster. Most people welcome this one-stop PT service. The re-attendance rate for the same problem for those discharged patients was 8.7%. The present study shows that PT plays a significant role in preventing unnecessary hospital admission and minimizing the AED re-attendance rate.
Co-location with:
