Authors (including presenting author) :
Chinn CT(1), Lam YHR(1), Pang CY(1), Yip HT(1), Lam PL(1), Tsui SH(2)
Affiliation :
(1)Physiotherapy Department, (2)Accident and Emergency Department, Queen Mary Hospital
Introduction :
Emergency Medical Ward (EMW) serves a significant portion of patients with musculoskeletal (MSK) problems. Patients demand an immediate treatment provider, physiotherapists serve as gate keeper in reducing hospital admission through pain management, ambulatory training and pre-discharge education on exercise. Suggestions made for direct discharge or admission to doctors help to reduce unnecessary hospitalization.
Objectives :
1. To evaluate the effectiveness of physiotherapy service in EMW
2. To compare the discharge destination suggested by physiotherapists and doctors
Methodology :
A data analysis of patients admitted to EMW from April to October in 2021 was studied. Diagnosis of patients were categorized into (1) low back pain (LBP), (2) knee, and (3) ankle. Pretest-posttest design was used to evaluate the pre and post intervention effectiveness. Pain level (Numeric Pain Rating Scale (NPRS)) and Mobility (Modified Functional Ambulatory Category (MFAC)) were measured. The suggested destination was also compared to the final destination. The readmission rate in 72 hours after discharge was evaluated.
Result & Outcome :
160 patients presented with the above MSK problems aged 19-97 were recruited in the study. There was significant reduction in pain among these patients with acute pain. The mean decrease in pain level was 1.62. The improvement of MFAC in all patients was also significant. However, improvement in MFAC was not significant in knee and ankle cases. The suggested destination of 132 patients (82.5%)made by physiotherapists matched the final destination of them. The prediction accuracy on the destination of patients was high, the specificity reached 94.5%. The readmission rate within 72 hours was 0.6% in the study period.
The physiotherapy service in EMW was effective in reducing pain, improving the MFAC of patients and hence reducing the admission and readmission. The decision making on discharge destination of patients had high accuracy which was helpful in identifying patients who could be directly discharge from hospital. Patient demand in immediate treatment by physiotherapists is shown to be effective in EMW setting.
