Authors (including presenting author) :
Chung WK(1), Tong KC(1), Ng KW(1), Wan SY(1), Mok LC(2), Mok WY(2)
Affiliation :
(1)Physiotherapy Department, Pamela Youde Nethersole Eastern Hospital
(2)Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital
Introduction :
A safe and appropriate discharge from hospital is important to ensure patient safety, reduce length of stay and prevent unplanned re-admission.
Collaboration between physiotherapists and Orthopaedic Department has long been established in PYNEH to safeguard patient’s safe ambulation and discharge. Fall risk assessment is performed on admission, self-ambulation in ward is allowed after physiotherapy assessment.
Physiotherapists also play an important role in triage and discharge planning. A “Home if Walk Well Program” (HWW) was provided by physiotherapists in orthopaedic wards since 2011 to facilitate appropriate discharge through triaging.
HWW is a pioneer to weekends and public holidays physiotherapy rehabilitation service, as additional physiotherapy sessions were provided during Sundays and public holidays.
Objectives :
(1) To facilitate safe and appropriate discharge of orthopaedic wards patients
(2) To triage and facilitate early transition of care
(3) To improve physiotherapy service efficiency during Sundays and public holidays
Methodology :
Orthopaedic wards patients indicated for HWW were triaged by physiotherapists in top priority assisting in fast-track service for early discharge. Fall risk assessment, transfer training, walking exercise, walking aids prescription and stairs training were provided. Telecommunication or face-to-face care-giver training were available for better discharge preparation. Patients who walked stable or care-giver available to assist in safe mobility were triaged as safe to discharge, others were triaged for continued training or early transition of care.
Result & Outcome :
Recent four years’ data (April 2017 to March 2021) including weekdays, Sundays and public holidays were reported. Among the patient pool, 37% were LL pain or injury, 26% were LBP, 17% were LL fracture, and 12% were UL fracture, pain or injury.
Overall, an average of 75% of patients were discharged same day after triaged. Others were triaged as continuation of care or transited to rehabilitation bed.
Patients planned discharge at weekend do not have to stay and wait till next weekday. This program facilitated about 270 patients discharged same day after triaged, equivalent up to 500 bed days being shortened.
HWW is effective in facilitating safe and appropriate discharge of orthopaedic wards patients. This demonstrated a shortening in length of stay and improved service efficiency on Sundays and public holidays.
