Introduction
Rehabilitation therapy is of paramount importance to help individuals recovering from illnesses and rebuild their lives in returning to the community. Increased rehabilitation intensity (including weekend therapy) has improved outcomes in different patient populations. A multidisciplinary rehabilitation program involving Physiotherapists, Occupational therapists, Nurses, Medical social worker and community NGO was launched on weekends and public holidays for stroke patients in Shatin hospital (SH) since 1 October 2017.
Objectives
To evaluate the benefit of the new multidisciplinary 365-days stroke rehabilitation service model
Methodology
Stroke patients admitted to SH from 1 October 2017 to 30 September 2018 receiving daily rehabilitation services were recruited (365 group). Their clinical and service outcomes including Modified Functional Ambulation Classification (MFAC), Modified Rivermead Mobility Index (MRMI), Bergs Balance Scale (BBS), Modified Barthel Index (MBI) and Functional Test for the Hemiplegic Upper Extremity (FTHUE) for functional independence; Montreal Cognitive Assessment Hong Kong Version (HK-MoCA); Response Time of initial assessment and treatment (RT); Length of Stay (LOS) and Patients & Caregivers Satisfaction Survey were collected and compared with the data of patients with the same diagnostic group captured in 1 October 2016 to 30 September 2017 (non-365 group).
Results & Outcome
Total of 185 patients were recruited in the 365 group. 87% was infarct type of stroke and 13 % was hemorrhagic. 95 of patients were male and 90 were female with mean age of 74.37 +/- 11.23 years old. Their functional and cognitive outcomes were all significantly improved (p< 0.05) in the 365 group compared with those of non-365 group (mean difference of MFAC change: from 0.65 to 1.09; mean difference of MRMI change: 4.46 to 7.99; mean difference in BBS change: 7.07 to 11.49; mean difference in MBI change: 7.89 to 12.11; mean difference in FTHUE change: 0.61 to 0.84; mean difference in HK-MoCA change: 0.84 to 1.34) with comparable LOS (20.732 +/- 8.77 days to 20.730 +/- 8.49 days). The RT was 53% faster than the non-365 group. For the Patients and Caregivers Satisfaction Survey, higher satisfactory scores were obtained in terms of treatment frequency, treatment intensity, response time, patients’ confident upon discharge, caregiver participation and overall service provision in 365 group compared with the non-365 group of patients. In conclusion, the newly-launched 365-days multidisciplinary service model in stroke rehabilitation achieved better functional and cognitive recoveries, higher patients and caregiver satisfaction to service with comparable hospital stay. Data collection should be continued and regularly review for continuous service improvement.
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