" At Home With Love" a model of Medical Social Collaboration in Public Estates at Shamshuipo

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Abstract Summary
Abstract ID :
Submission Type
Authors (including presenting author) :
Hui SLF (1), Wong SY (1), Wong LY (1), Chan YHK (1), Tse LKS (1), Chow YH (2), Fung T (2)
Affiliation :
(1) Community Nursing Services, Caritas Medical Centre, (2) South Kwai Chung Social Services
Introduction :
South Kwai Chung Social Services (SKCSS) was a Non-governmental Organization which aimed to provide community health and social services to the elderly in districts by partnership with other community organizations. At 2015, SKCSS had appplied the Community Investment and Inclusion Fund (CIIF) from the Government of Hong Kong Special Administrative Region to develop "At Home With Love" project with a cross-sectoral health support network in 3 Public Estates (Fu Cheong, Wing Cheong and Nam Cheong Estates) in Shamhuipo. The Community Nursing Services and Nursing School of Caritas Medical Centre, Sik Sik Yuen's District Services Community Centres for Senior Citizens and Tung Wah Group of Hospitals Yu Mak Yuen Integrated Serivces Centre were invited to join the project.
Objectives :
1. Collaborate with a variety of professionals from health and social organization to promote healthy and caring society. 2. Enhanced community-based health support to people with chronic diseases. 3. Enhanced the social participation of the citizens through volunteer team.
Methodology :
Community Nursing Services as a partner of this project, it provided support in the health consultation and primary prevention. Fu Cheong Community Nurse Center acted as a nurse clinic for the clients to access nursing and health services. Scope of Services in Community Nurse Center: 1. Provide primary health screening. 2. Delivery monthly health talk. 3. Monitor of blood sugar and cholesterol level. 4. Provide individual Nurse Consultation Serivces by Community Nurses 5. Participte health exhibition every 6 months. 6. Provide E-health check for people with chronic disease e.g. DM.
Result & Outcome :
Health talk: 25 sessions of health talk were provided by Community Nurses with 1021 attendees. The attendees expresssed the talk could enhance their knowledge and disease management skill. Early detection of chronic diseases: Through bimonthly health screening, 44 clients were found hyperlipidemia, 8 clients had both hyperglycemia and hyperlipidemia, 5 clients had hypertension, 5 clients had hyperglycemia, and 4 clients had both hyperlipidemia and hypertension. In health exhibition, 9 clients were found osteoporosis and 4 clients had mild cognitive impairment. All these clients were referred to GOPC or appropriate specialists. Reduction of AED attendance and unplanned admission: 186 clients were seen in nurse clinic throughout these 3 years. The AED attendance and unplanned admission of 90 days before and after conuselling was studied. The AED attendance was reduced 14.29% and the unplanned admission was reduced 17.65% after consultation by Community Nurses.

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