In-house clinical audit on Work Rehabilitation Services by Occupational Therapy Department of North Lantau Hospital – a three year study

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Abstract Description
Abstract ID :
HAC588
Submission Type
Authors (including presenting author) :
Cheng KW(1), Chong HC(1), So TW(1)
Affiliation :
(1)Occupational Therapy Department, North Lantau Hospital
Introduction :
North Lantau Island is a newly developing district in Hong Kong. A review of out-patient Occupational Therapy services statistics revealed that an average of 35% service volume was related to Work Rehabilitation in recent years in North Lantau. Although this specialty service used to be provided by cluster Designated Work Rehabilitation Center (DWRC), such service is constantly requested by patients who are either living or working in Lantau district. The major benefit being the reduction of unnecessary long travelling especially when patients still suffering from painful symptom and dysfunctional mobility. In order to align the service quality with the ten DWRC, we adopt the “OTCOC Guidelines (2013)” to conduct an in-house clinical audit. A total of 90 case files were randomly retrieved from 2016 to 2018 and reviewed by supervisory grade therapists. This study aims to review patients' anticipated return to work rate after adoping the guideline and our compliance rate to the guideline.
Objectives :
To investigate the followings:
1. Patients’ anticipated return to work rate 2. Compliance rate to OTCOC Clinical Guidelines on Work Rehabilitation (2013)
Methodology :
The standardized CMS report on work rehabilitation was adopted as mandate practice. In-service training conducted for an in-depth understanding of work rehabilitation including goal-directed interviewing technique for triage of most appropriate work disability management strategies (work hardening, job accommodations and vocational resettlement). OTCOC’s audit criteria on work rehabilitation program was adopted for documentation and review.
Result & Outcome :
The outcomes were encouraging. All initial assessments were conducted within 4-weeks’ after receiving referrals, aiming at timely triage and provision of appropriate work disability management strategies. Course of intervention found decreasing from 4.9 to 3.7 months. The anticipated return to work rate was more than 67% in 2018. The overall compliance rate to “OTCOC Guidelines” was 86%. Full compliance obtained in fulfilment of program admission and termination criteria, program entry risk stratification, treatment frequency & intensity, documentation of assessment results /outcome, treatment goals and plan with CMS. The only non-compliance being the extra time lag between re-assessments for some cases, especially at the later stage of intervention; which may be due to stable condition of patients, practical compromise to speed up the first contact with needed patients and partially contributed by patient’s request to match appointment with physician’s follow-up schedule.

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