Authors (including presenting author) :
Lam K F, Lau L, Hui H T, Lam Y Y, Chan L C
Affiliation :
Department of Occupational Therapy , Tung Wah Eastern Hospital
Introduction :
According to hospital authority Strategic Service Framework for Rehabilitation Service in 2018, one of the service gaps identified is limited coverage for in-patient rehabilitation during weekends and public holidays (PH). The importance of early stroke rehabilitation was highlighted by the guidelines published by the American Stroke Association. Clinical studies on rehabilitation management showed that intensive rehabilitation therapy improves patients’ functional recovery to rebuild their lives and return to their community and work activities. During COVID-19 Pandemic, with physical distancing and social isolation, access to stroke rehabilitation services was challenging. Pre-discharge preparation including caregiver training, home assessment and intervention with caregiver via TELE-care during weekend and PH facilitated safe discharge and reduced caring stress. A stroke rehabilitation program on weekends and PH has been implemented in Tung Wah Eastern Hospital (TWEH) since Oct 2020.
Objectives :
To evaluate the effectiveness of the 365 stroke rehabilitation on functional recovery and service outcome
Methodology :
Patients with Stroke admitteD from Oct 2020- Sep 2021 that receiving 365 rehabilitation services were recruited (365 group). Their clinical and service outcomes Modified Barthel Index (MBI), Functional Test for the Hemiplegic Upper Extremity (FTHUE) for functional independence; Montreal Cognitive Assessment Hong Kong Version (HK-MoCA) for cognitive function; Response Time; Length of Stay (LOS) and Patients Satisfaction Survey were collected and compared with the data of patients with the same diagnostic group captured in Oct 2019- Sep 2020 (non-365 group).
Result & Outcome :
From Oct 2020 to Sep 2021, 248 patients with mean age of 71 years old received the 365 rehabilitation service. Their functional outcomes were significantly improved in the 365 group compared with non-365 group (change in MBI mean difference: 10.21 to 15.24, p=0.000; change in FTHUE mean difference: 0.43 to 1.21, p=0.000) with comparable LOS .The response time of initial assessment was 25% faster than the non-365 group. For the Patients Satisfaction Survey, all patients agreed 365-day rehabilitation enhanced functional recovery, treatment intensity and reduce carer stress. Conclusion: Better functional recovery and service outcomes were achieved in the 365 stroke rehabilitation program with comparable LOS.
