Authors (including presenting author) :
Chan YL (1), Chan YP(1), Suen WC(1), Tsui SY(1)
Affiliation :
(1) Occupational Therapy Department, The Hong Kong Buddhist Hospital
Introduction :
Early identifying discharge destination can facilitate a safe and early discharge with better predischarge preparation, such as carer education, aids prescription and home modification. In 2021, with using a tool called Home Discharge Readiness Scale (HDRS), occupational therapists conducted a pilot study to predict discharge destination on patients with hip fracture
Objectives :
To evaluate the prediction power of HDRS for discharge destination
Methodology :
Subjects were patients with hip fracture with and without surgery. They were evaluated their discharge destination with HDRS, when they were evaluated at first initial intake (initial HDRS) by occupational therapists, at 2nd week (middle HDRS) and before discharge (final HDRS). Based on patient, carer and home environment factors, discharge destination in HDRS was identified. With comparing with the predicted discharge destination with use of HDRS and the actual discharge destination, the prediction power of HDRS were evaluated. Outcome measures were: (1) number of patients with HDRS matched with actual discharge destination, (2) patient’s functional outcome including Modified Barthel Index (MBI) and Abbreviated Mental Test (AMT) at initial and final assessment.
Result & Outcome :
Result: In 2021, from July to September, 37 patients recruited and 67.6% were females. The number of patients with HDRS matched with actual destination were 28 and 31, at initial HDRS and final HDRS, with the prediction power of HDRS of 75.7% and 83.8% respectively. For those cases unmatched with actual destination, 55.6% was due to change decision of carer. The average length of stay was 24.4 days (25.6 days last year). The average age were 85.8 years old. 56.8% of patients were discharged back to home. With early identifying discharge destination, early preparation for discharge were obtained, including home assessment and carer education to ensure safe discharge to community. There was improvement in MBI from 52.4 to 63.2 after rehabilitation. There was no change in AMT. Conclusion: With high prediction power, HDRS can be considered as reference in predicting discharge destination. Apart from patient’s functional performance and home environment, readiness of the carer is a crucial factor for patient’s discharge destination. Acknowledgement: HDRS used in this study, adopted from HDRS, which was developed by Occupational Therapy Department in Queen Elizabeth Hospital.
