Authors (including presenting author) :
Shadow NG HW(1), Adrian Leung KY (1), Frances Louie TM(1)
Affiliation :
(1)Occupational Therapy Department, Alice Ho Miu Ling Nethersole Hospital
Introduction :
Hospital readmission can lead to poorer patient outcomes and increased health care costs. Literatures revealed that occupational therapy (OT) services played a significant role in safe home discharge and minimizing hospital readmission rate by providing suitable follow up, from transition from hospital to community, especially for frail elderly with complex needs. With the aim to reduce utilization of the ever-increasing service demand in accident and emergency department (AED), active screening with fast-track OT interventions focused on fall prevention was commenced in emergency ward (EMW).
Objectives :
To evaluate if proactive fast-track approach of OT services in EMW can address challenges of elderly patients at fall risk in AED, ensure safe home discharge and prevent hospital readmission due to fall.
Methodology :
Occupational therapists in Alice Ho Miu Ling Nethersole Hospital proactively perform screening for potential cases with fall risk every day in EM ward. Occupational therapists actively involved in the multidisciplinary discharge planning process and identify patients who require follow up in community or outpatient OT services in order to minimize unplanned readmission.
Result & Outcome :
Between September 2022 and August 2023, 431 cases (56% female and 44% male) were recruited, with a mean age of 76 years old. The majority of cases were diagnosed with fall (30%), dizziness (28%), and low back pain (12%). 62% of cases were referred for fall prevention, 12% for pain management program, 11% for ADL assessment and training and 8% for cognitive assessment. 329 cases (76%) were successfully discharged home directly, while 120 cases (37%) were referred to community or outpatient follow up OT services. Only 11 patients (2.6%) re-attended the AED within 28 days due to falls.
Proactive OT services within EMW have demonstrated effectiveness in early identification of patients at risk of falls. The provision of ambulatory OT services has the potential to decrease hospital readmissions resulting from falls. In order to extend the reach of these services to a greater number of patients, occupational therapists are suggested to expand involvement in EMW services and further contribute in the gatekeeper team of emergency healthcare.
