A cost-effective Triage System for Physiotherapy Out-patient Department in Queen Elizabeth Hospital, Kowloon Hospital and Hong Kong Buddhist Hospital

Abstract Description

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Authors (including presenting author) :

Chau DKW(1), Chan ACM (1), Chau RMW(2), Poon MWY(3), Leung KKL(2), Chow IHW(1), Cho JSY(1)

Affiliation :

(1)Physiotherapy Department, Queen Elizabeth Hospital
(2)Physiotherapy Department, Kowloon Hospital
(3)Physiotherapy Department, Hong Kong Buddhist Hospital

Introduction :

Growing demand in Physiotherapy (PT) Out-Patient Department (OPD) services was a challenge with the expanding patient volume and scope of PT. To maximise the value of available resource, an organised triage system helps to stratify case to timely service. The Physiotherapy Coordinating Committee (PTCOC) published the ‘Triage Criteria for Physiotherapy Adult Out-patient Service (the criteria)’ in 2017 to align the practice among clusters. Initial PT appointment was given by a trained clerical staff on the same day or after when patient present the referral. A second triage was performed by Senior Physiotherapist or experienced Physiotherapist I within 7 working days to assess the appropriateness of the given appointment and advance it when indicated. Issuing of the initial PT appointment by clerical staff significantly reduce patient’s waiting time and promote better cost-containment.

Objectives :

This study aimed to assess the cost-effectiveness and the accuracy of the PT OPD triage system and its compliance to the criteria in selected hospitals in Queen Elizabeth Hospital, Kowloon Hospital and Hong Kong Buddhist Hospital.

Methodology :

An audit was conducted in November 2018. Three percent from all adult PTOPD new case was sampled. The compliance to the criteria in triage logistics and the timeliness of the second triage was assessed. The accuracy of the first triage by clerical staff was also investigated.

Result & Outcome :

A total of 81 appointments booked in October 2018 were reviewed. Among the sampled record, 32.1 %,17.3 % and 50.6% belongs to the triage category Priority 1 (P1), Priority 2 (P2) and Routine (R) respectively. Full compliance was observed in the record of the staff’s name and rank in all triage categories and all second triage was conducted within 7 working days after first triage. All staff responsible for the second triage was suitable with reference to the description stipulated in the criteria. All initial appointment was given according to the appropriate category in the first triage in the sampled record and no initial appointment requires advancement in the first triage.
The triage system in the 3 hospitals promote the appropriate utilisation of rescource to serve the growing demand. First triage by clerical staff followed by a second triage from senior physiotherapist or experienced Physiotherapist I reduced patient waiting time and promote cost-containment. The triage system in place was found to comply with the PTCOC criteria and it accurately stratify patients into the appropraite triage category.