Occupational Medicine-Orthopaedics Joint Clinic as a means to facilitate return-to-work for healthcare workers

Abstract Description

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Authors (including presenting author) :

Kwan Y, Yau LM, Pun LY,Kwok PK, Choi TL, Chan PF, Chao DVK, Cheng HC

Affiliation :

1. Department of Family Medicine and Primary Health Care, United Christian Hospital 2. Occupational Medicine Care Service (OMCS), Kowloon East Cluster (KEC) 3. Department of Orthopaedics and Traumatology, United Christian Hospital

Introduction :

Musculoskeletal problems are a common cause for work disability, which may further complicated by psychosocial factors. These can cause difficulty in return-to-work (RTW). Since delayed RTW can be detrimental to workers’ well-being, prompt and multidisciplinary management is essential. In May 2015, Kowloon East Cluster (KEC) set up a joint occupational medicine-orthopaedics clinic. Healthcare workers with complicated musculoskeletal conditions were managed in the joint clinic. The joint clinic enabled face-to-face discussion on management and RTW plan, between occupational medicine healthcare team and orthopaedics specialist. The joint clinic also triaged cases which required further fast-track orhopaedics sub-specialist management.

Objectives :

To evaluate characteristics and RTW outcomes of patients attending the joint clinic

Methodology :

Inclusion criteria: Patients attended the joint clinic from 1st May 2015 to 30th June 2018 Clinical data: retrieved from computerized medical record system
Sick leave data: retrieved from Human Resources Department

Result & Outcome :

Total 68 patients were included in the review. The most prevalent age group was age 41-50 years old, with mean age 42.7 years old. Most were supporting staff (46, 67.6%) and nurses (18, 26.4%). Female was more prevalent gender (60, 88.2%). Back (25, 23.1%), shoulder (14, 13.0%) and neck (12, 11.1%) were the most commonly affected musculoskeletal systems affected (Fig 1).
Before attending the joint clinic, 50% of patients were on sick leave. There was a progressively rising RTW rate after attended the joint clinic (post 1-month 50%, post-3 month: 22.1%, post-6 month: 13.2%). More workers were unable to tolerate full day modified work after attended the joint clinic (post 1-month: 13.2%, post-3 month: 13.2%, post 6-month; 11.8%). The proportion of workers having full duty was significantly increased after attended the joint clinic (before 2.9%, post 1-month 7.4%, post 3-month 11.8%, post 6-month 19.1%) (Fig 2). Conclusion
The joint clinic was shown to facilitate healthcare workers with complicated musculoskeletal problems to have earlier, sustained RTW. Since back, shoulder and wrist/forearm were common musculoskeletal conditions leading to prolonged work disability, prevention strategies could be planned accordingly.