Effective Assessment of the Enhanced Structured Physiotherapy Out-patient Triage System in patients with Neck and Back conditions of Kowloon Hospital

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Authors (including presenting author) :
Leung KKL(1), Chau RMW(1), Chan ACM(2), Chau DKW(2), Poon MWY(3), Lau MHL(1), Chan KKK(1)
Affiliation :
(1)Physiotherapy Department; Kowloon Hospital; (2)Physiotherapy Department, Queen Elizabeth Hospital; (3)Physiotherapy Department, Hong Kong Buddhist Hospital
Introduction :
Long waiting time has been the universal challenges in most healthcare services. Structured triage system has been implemented in the KCC Physiotherapy(PT)-out-patient(OPD) i.e. Queen Elizabeth Hospital, Kowloon Hospital and HK Buddhist Hospital(pre-cluster boundary re-delineation) since 2015 in order to provide reasonable practically timely services to meet patient’s demands. The triage system assigns all patients into priority-1-urgent(P1), priority-2-semiurgent(P2) and routine-stable(R) categories according to patient’s conditions in compliance to PTCOC guidelines.
Objectives :
Back & neck conditions constituted the major clientele in OPD. The aim of this project is to investigate the effectiveness of this KCC PT-OPD Triage System in distributing prompt services to patients with neck and/or back conditions.
Methodology :
Descriptive and clinical data was captured with a structured survey from patients who were discharged from KCC PT-OPD between 1.9.2016 to 31.12.2018 and analyzed with correlation analysis for subgroup analysis.
Result & Outcome :
A total of 3,981 patients’ records with diagnosed neck and/or back conditions, accounting for 31% of the total recruited records, were obtained. The mean age of these sampled patients was 57.7+/-14.4 with comparable male-to-female ratio, and among these patients, approximately 69.8% were referred from KCC included GOPC(38.8%) and O&T(21.4%). Majority of these patients were assigned to R category(78%) and 9.0% and 12.9% were in the P1&P2 categories respectively. The average recovery percentage was 66.1+/-24.6% with average attendances of 11.6+/-11.6. The average time gap between referral date and appointment booking was 9.7+/-28.1days while that between appointment booking and first appointment was 109.8+/-61.3days. The waiting time of KCC PT has been maintained favorably in benchmark with HA average. Upon subgroup analysis, the age and the total number of attendance were similar among all triage groups with P1 group showed slightly higher recovery percentage(72.0+/-22.9%) than P2 and R groups(65.6+/-25.1%&65.6+/-24.6% respectively) in these sampled patients(p=0.001). The correlation between total number of attendance, recovery percentage and the time gap between booking date and first appointment was insignificant in all triage groups. The findings reflected that the triage system implemented in KCC PT-OPD is effective in scheduling patient’s appointment. The waiting time did not impact on the recovery of patients with neck and back conditions while effectively prioritized needy patients(P1&P2) with opportune PT services. The project contributed to effective monitoring means for waiting time of the high volume clientele with cautious and rational resources utilization in meeting ever-increasing service demand.

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