Multidisciplinary Co-Cared Triage Model to Enhance Early Interventions for Non-operative Spinal Outpatients

This abstract has open access
Abstract Summary
Abstract ID :
HAC848
Submission Type
Presentation Upload :
If the file does not load, click here to open/download the file.
Authors (including presenting author) :
Wong WL(1), Law SW(2), Cheuk C(3), Choi YKS(3), Chun YWE(1), Kam SW(1)
Affiliation :
(1)Physiotherapy Department, Prince of Wales Hospital, (2)Department of Orthopaedics & Traumatology, Prince of Wales Hospital, (3)Department of Family Medicine, Prince of Wales Hospital
Introduction :
Service demand for specialist intervention in outpatients with spinal pain is overwhelming and is still in increasing trend. Patients are often required to wait for years to attend a specialist consultation in public sector. In Prince of Wales Hospital (PWH), a multidisciplinary co-care by Orthopaedics & Traumatology (O&T), Family Medicine (FM) and Physiotherapy was started in October 2017 to tackle this problem. This is a new fast-track spinal triage program to provide early medical and physiotherapy interventions for patients with non-operative spinal pain.
Objectives :
 To evaluate the process time required for non-operative spinal cases to receive specialist care and/or physiotherapy treatment  To evaluate the new service model in view of percentage of case required O&T follow-up after FM consultation and clinical outcomes
Methodology :
Spinal cases referred to O&T Department, PWH, unless with serious pathology written on the referral, were triaged in PT Department. After individual assessment was carried out by a physiotherapist, suitable routine case without red flags sign would be selected to enroll in the new co-cared model. Endorsed by the O&T doctor, selected cases would be referred to FM instead of putting into routine O&T waiting list. Cases would then be looked after by Specialist in FM; physiotherapy referral would be given if indicated.
Result & Outcome :
From October 2017 to Nov 2018, 509 cases were selected for co-care. This accounted for 25.5 % of all routine O&T spinal cases in the period. Time to first FM consultation was 4 to 17 weeks; the waiting time for O&T spinal routine cases was about 130 weeks before the commencement of this collaboration. Among all cases, only one case required O&T follow-up after FM consultation. The waiting time for physiotherapy was 2 to 8 weeks. The Numeric Global Rating of Change Scale of patients receiving full course of physiotherapy was 6.4. The Numeric Pain Rating Scale improved from 5.0 to 2.2 (P<0.05). For low back pain cases, the score of the Roland Morris Disability Questionnaire improved from 11 to 7 (P<0.05), and the score of the Northwick Park Neck Pain Questionnaire for neck pain cases improved from 41% to 15% (P<0.05). Conclusion: With seamless multidisciplinary collaboration, non-operative spinal outpatients could have faster access to specialist care and indicated treatments with promising clinical outcomes.

Similar Abstracts by Type

Abstract ID
Abstract Title
Abstract Topic
Submission Type
Primary Author
HAC720
Clinical Safety and Quality Service I
HA Staff
Maria SINN Dr
HAC456
Enhancing Partnership with Patients and Community
HA Staff
Donna TSE
HAC1262
Enhancing Partnership with Patients and Community
HA Staff
S F LEE Dr
HAC997
Clinical Safety and Quality Service II
HA Staff
K L CHAN