Authors (including presenting author) :
Leung KKL, Lau MHL, Lam CPY, Chau RMW
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
The highly transmissible Omicron variant of COVID-19 has prompted an unprecedented surge of infection in Hong Kong since January 2022.1 Facing the abruptly deteriorating development of the fifth pandemic wave, stringent infection control measures and manpower rescheduling were executed in hospitals. Contingent structure and workforce re-design was implemented at the Outpatient Physiotherapy Department of Kowloon Hospital(KH-PT-OPD), from February to May 2022, to mitigate spread of virus and contact tracing purposes whilst harvesting workforce efficiency for tackling the contextual manpower shortage. Instead of working in various treatment venues catering for different clientele and for broadening of clinical exposure of physiotherapist(PT), PT staff were designated to work in single venue to minimize cross infection, allow easy contact tracing2 and deliver focused specialized care for target patients at routine daily work. Explicit clinical handover was exercised to assure the quality of care despite change of case physiotherapist. Nonetheless, potential shortcoming might exist affecting the built rapport and subtle details of handling. Donabedian structure-process-outcomes framework was adopted for evaluation.
Objectives :
To evaluate the impact of contingent structure and workforce re-design for tackling infection control measures and manpower shortage on Outpatient Physiotherapy service on the patient’s outcome
Methodology :
A retrospective longitudinal case review was conducted to evaluate the outcomes of patient during studied period for measures implementation(Group_1=first patient appointment from 1.2.2022 to 31.5.2022) and conventional arrangement period(Group_2=1.6.2022 to 30.9.2022). Outcome data included pain reduction, self-perceived recovery, and the number of attendances of patients with musculoskeletal conditions.
Result & Outcome :
Data of 870 patients were retrieved(Group_1,n=492; Group_2,n=378). Significant within group improvement in pain reduction exceeding minimal clinically important difference(MCID) and recovery was found(p<0.05) for both groups. No between-group difference was found in patients’ age(mean:61.47±12.88years;p=0.527), pain reduction(Group_1=mean:3.53±2.22;Group_2=mean:3.53±2.11;p=0.976), self-perceived recovery(Group_1=mean:63.5±22.1;Group_2=mean:65.0±24.1;p=0.369), and the number of attendances(Group_1=10.4±3.9;Group_2=10.0±4.2;sessions;p=0.169). No significant correlation was found between the contingent structure and workforce measures with all outcome parameters.
Our findings demonstrated that the contingent structure and workforce re-design together with corporate staff safety measures and local staff empowerment/engagement strategies was effective in achieving comparable significant pain reduction and satisfactory self-perceived recovery without impact on clinical nor process outcomes. Our service redesign embracing some crucial components in Physiotherapy workforce planning and preparation recommended by recent literature2,3 was found to be reasonably practicable and effective measures at local ambulatory care setting to curb potential transmission of coronavirus whilst achieve desirable outcomes and harvest workforce efficiency amidst pandemic crisis.
