Authors (including presenting author) :
Lam HW(1), Lam CM(1), Lam HW(1), Cheung TY(1)
Affiliation :
(1)Occupational Therapy Department, Tuen Mun Hospital
Introduction :
Hong Kong Health Care System is facing the big challenge of increasing elderly population. The projection figure will be 27% of the whole population by 2031. Assistive technology is one of the core interventions of Occupational Therapy (OT) to support the Elderly to overcome the limitations in daily activities and maintain functional independence (Dishman, Duckart & Hardman, 2021). From Jan 2020 to Dec 2021, 118 patients were referred to Medical & Geriatrics team of OT Out-Patient Department (OPD) in Tuen Mun Hospital for assistive device services. Majority of referrals (96%) were for wheelchair prescription and replacement. In conventional clinical practice, OTs would screen patients’ needs and urgency from Clinical Management System (CMS). Waiting time ranged from 8-12 weeks. During COVID-19 pandemic in Hong Kong, the “new normal” inspired us to adopt technology into our clinical practice to improve the quality of service. In Jan 2020, A pilot project was commenced to incorporate tele-interview before initial assessment for assistive device prescription in OT-OPD of Tuen Mun Hospital.
Objectives :
To promote timely need assessment and risk identification so as to improve workflow efficiency using tele-rehabilitation model in OT-OPD
Methodology :
Since Jan 2020, OTs conducted tele-interview for the new referrals for assistive device within 7 working days. The tele-interview mode incorporated zoom app usage to gather information on patients’ functional independence, social support and home environment with sharing of photos/videos and educational information. Earlier appointment would be arranged if patients exhibited urgent needs and risks. For example, malfunction of power wheelchair battery with fire risk during charging. Moreover, information on assistive device selection, financial / procurement procedure and community support organization could be given to patient for preview through email while waiting for time before the first appointment. Thus workflow efficiency was enhanced.
Result & Outcome :
There were 103 patients referred for assistive device prescription from Jan 2018 to Dec 2019 and 118 patients from Jan 2020 to Dec 2021. By comparing these two periods, there was an 15% increase in the referrals. Amongst the 118 patients, 34 (28.8%) patients’ appointments were advanced after tele-screening introduced (ranged 1 to 6 weeks). The mean new case waiting time was shortened from 10.9 weeks to 8.7 weeks. Utilization of tele-screening in OPD work flow has great efficiency boost in prioritizing patient’s need and thus promote more timely intervention to patients despite the pressing demand in services and challenges during pandemic.
