Authors (including presenting author) :
Law WY(1), Wong WCJ (1), Ku WN (2), Cheng CK (3), Chan SY (1), Cheung CFM (2), Kwok ML (2), Lam, SH (1), Lee KL (1), Tang WY (1), Tse HY (3), Yau KY (3), Kong SB (2), Wu A (3)
Affiliation :
(1) Department of Occupational Therapy, Princess Margaret Hospital (2) Department of Occupational Therapy, Yan Chai Hospital (3) Department of Occupational Therapy, Caritas Medical Centre
Introduction :
Functional declined prior to major surgery is common especially in elderly patients. The Enhancement Program of Perioperative Management of Surgical and Orthopaedic Patients in Kowloon West Cluster was commenced in October 2020. Occupational Therapy (OT) aims at optimizing patient’s self-care abilities, managing home environmental hazards and preventing post-operative complications. In this program, OT provides one-stop rehabilitation service from pre-operative, operative and post-operative care for patient undergoing operation. This enhances high risk patients for early safe discharge.
Objectives :
The review aims at concluding the service profile and evaluating the effectiveness of OT by standardize outcome measures in the enhanced perioperative program.
Methodology :
It is a retrospective analysis on patients recruited between the period of 1 October 2020 and 30 September 2022. Descriptive statistics was used to describe the characteristics of the service provision and rehabilitation outcomes.
Result & Outcome :
Among the 1932 patients recruited, 1767 patients were discharged from program during the review period. The mean age of patients was 67.7. More than 90% of the patients received both in-patient and out-patient services and around 30% of the patients received community occupational therapy service with home modification and education. Out of the 1767 patients, 1364 patients completed OT program. The mean Modified Barthel Index score at pre-morbid, immediate post-operation, pre-discharge and end of the program were 95.4, 50.4, 77.8 and 95.4 respectively. The pre & post WHO-5 average score were 61.0 and 68.2 respectively. The pre & post modified Vancouver Scar Scale average score were 4.2 and 3.3 respectively.
The results showed the fact that patient’s functional performance would be affected immediate after operation. However, with the one stop comprehensive OT intervention, it served well to improve patient’s functional performance and enhance safe discharge. Meanwhile it optimizes patient’s functional status compatible to premorbid state which facilitate patient to re-integrate into the community. 90% of the patients returned home care upon discharge. Furthermore, the program can improve the general wellness of patients and also reduce the complication of scarring issue.
In conclusion, the OT one-stop rehabilitation service in the enhancement program can provide significant benefits to the patients compare with conventional rehabilitation service.
