Authors (including presenting author) :
Tong YC(1), Kwan SMV (2), Lau SF (2), Cheung KL(2), Luk W (2)
Affiliation :
(1)Occupational Therapist, (2) Doctor, Department of Family Medicine and Primary Health Care, Kowloon West Cluster
Introduction :
The management of patients with injury-on-duty (IOD) has been challenging on services of General out-patient clinic (GOPC) as patients are frequently attending GOPC with annual dozen thousand attendances. A new occupational therapy Early-return-to-work (OT ERTW) program, collaborating with doctor and SOPD OT, was set up in West Kowloon (WK) GOPC for IOD patients in ShumShuiPo district (SSP) since May 2017. It aims at timely intervention, empowerment on patients’ IOD management, active participation, and the final goal is their resumption of job and productivity to the society.
Objectives :
To review the program effectiveness, patient outcome and satisfaction of patients and doctors for the new OT ERTW program.
Methodology :
This retrospective cohort study included IOD patients regularly attending GOPCs in SSP. OT will start the empowerment and ERTW training in GOPC and triage motivated patients to a designated doctor’s IOD clinic and further OT intensive work hardening in SOPD. Patient outcomes were analyzed by the Paired t-test of pre- and post- Numeric Global Change Rating Scale (NGCRS), Numeric Pain Rating Scale (NPRS), power grip and SLR (for relevant condition) after completed OT training. The access time to OT services, patient profile and job resumption rate were measured. Satisfaction of patients and doctors were assessed by a 10-point scale survey.
Result & Outcome :
316 patients were referred to OT ERTW program in WK GOPC during May 2017 to Dec 2018. Mean age was 50 (ranged 21-71, SD=12)and most of them were male (59%), suffered from back injury (27%) and heavy duty worker (86%). The mean access time to first OT assessment from IOD was significantly shortened when comparing that prior to program (8 to 2 months, P< 0.005). 42% patients, requiring intensive work hardening, were triaged to SOPD OT program. 17% patients were triaged to the designed doctor IOD clinic in GOPC whereas 30% pending ORT services. Upon OT discharge, they had significant improvement on NGCR scale (4+/-2 to 7+/-2.2, P<0.001) and NPR scale (6+/-1.8 to 3+/-2.1, p<0.001) and power grip (10+/-7.1 to 17+/-8.6 kg, p<0.001) and SLR (55+/-19 to 74+/-17 degree, P<0.001). Thirty patients and seven doctors completed satisfactory survey. The satisfaction on the empowerment of IOD management (7+/-2) and the feedback from both patients and doctors (8+/-2 and 9+/-1, respectively) were all satisfactory. 52% patients resumed job within 3-month post-MAB or completed ERTW program. Potential factors for job resumption were charted and analyzed.
Conclusion:
These preliminary outcomes showed positive and facilitating on patient job resumption. The paradigm shift of early IOD management in primary care setting demonstrated promising outcomes and additional resources could be implied for extent of IOD program in GOPC.
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