Introduction
Occupational therapist (OT) are often required to conduct home environmental assessment to ensure safety before discharge as part of their role in rehabilitation teams. To improve the timeliness of occupational therapy home visits for discharge planning, a technology-assisted care model on pre-discharge home assessment was developed in medical convalescence wards of Tuen Mun Hospital. The carers involved in the service needed to fill in a specific home assessment form, and OT received patients’ home photos and measurement forms by using a designated e-mail address and WhatsApp platform. OT assistants were assigned to organize the home photos after information received.
Objectives
(A)To reduce the number of referrals to Community OT team and time during home visit after the home photos and measurement screening. (B)Through online platform, early intervention of home modification could be conducted to facilitate health care team in pre-discharge planning.
Methodology
This care model was implemented in medical rehabilitation services in Tuen Mun Hospital. After conducting comprehensive initial assessment by OT, if home measurement and home photos were indicated for discharge planning, a standard assessment form would be given to patients’ carers. Carers could follow the instructions to measure home environment, take home photos and send back to OT afterwards. After receiving the information, OT discussed with patient and carers about home environment interactively during carer training sessions. Environmental intervention included prescription of assistive device, home modification and advice on home safety. OT could simulate actual home environment for patients to practice skills in managing threshold at toilet entrance and bathtub transfer. Furniture re-arrangement would be suggested to facilitate accessibility of wheelchair use. After screening the information collected, OT might consider to refer community OT team to conduct on-site home visit for major constructional home modification if needed.
Results & Outcome
From January to December 2018, 450 medical rehabilitation patients adopted technology-assisted care model on pre-discharge home assessment. 110 cases were referred to pre-discharge on-site home visit. This care model could stratify our patients to fast-track home safety intervention, greatly reduce the travelling time by OTs, especially some remote village house, thus the waiting time of home assessment was shortened. The technology-assisted care model on pre-discharge home assessment by occupational therapists was successfully implemented. This could increase the workflow efficiency of OT in services delivery and facilitate pre-discharge planning.
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