Authors (including presenting author) :
Chan WY (1), Wong MK (1), Leung TM (1), So TWP (1), Dr. Wong OF (2)
Affiliation :
(1) Occupational Therapy Department, North Lantau Hospital
(2) Department of Accident and Emergency
Introduction :
The Occupational Therapy (OT) intervention model in the pilot GEM program at NLTH, launched from October 2019 to January 2020, had demonstrated various benefits to frail elders including optimizing functional performance and facilitating safe discharge. Although community OT (COT) is an effective means in safe community re-integration, immense manpower is required which limits the provision of such service to all patients with high fall risks. Hence, the Person-Environment-Occupation (PEO) checklist was adopted as a stratification mechanism for guiding the provision of need-specific interventions.
Objectives :
To review the effectiveness of PEO checklist to stratify OT intervention in GEM program.
Methodology :
Patients in Emergency-Medicine ward who were recruited under GEM program and stratified as high fall risk, were assessed by PEO checklist to identify the need for home visit or community rehabilitation. The higher the score in PEO checklist implies more fall-related risk factors.
Result & Outcome :
47 patients were recruited for GEM from September 2021 to June 2022 with mean aged 82. 37 patients were classified as high fall risk status upon admission and PEO checklist was used to assess need-specific OT intervention. After offering standard functional training and fall prevention education in in-patient phase, the overall functional performance of patients under GEM have showed improvement with an increase of mean MBI from 72 to 77. 6 patients were offered home visit due to more prominent “environmental” risk factors. The mean Modified Barthel Index (MBI) of these patients increased from 68 to 76. The mean PEO risk score decreased from 12 to 7.5. The other 5 patients who had notable risk factors in personal or occupational aspects were offered community rehabilitation upon discharge. The mean MBI of these patients increased from 79 to 88. 15 patients who remained high fall risk upon discharge, were not offered COT mainly due to change of discharge destination to institution or refusal of post-discharge service.
To conclude, the use of PEO checklist provides a framework for occupational therapists to stratify promptly on patients’ specific needs and to prioritize OT’s interventions with existing resources allocated.
