Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Yeung EMP (1) Chan JSP(2),Chak NNT(2),Cheung GCM(2),Wong JTM(2), Tai ML (1), Leung KKL(2), Yu TKK (1)
Affiliation :
(1) Department of Rehabilitation (2)Physiotherapy Department, Kowloon Hospital
Introduction :
Jockey-Club-Integrated-Rehabilitation-Day-Centre(JCIRDC) commenced service in January2022 as an extension of the Geriatric-Day-Hospital(GDH) at Kowloon Hospital(KH). The center incorporates the Neuro-Day-Rehabilitation(NDR) specifically to young neurological adults.
Objectives :
The aim was to evaluate the role of NDR in JCIRDC to promote early-discharge of in-patients(KH) stroke and to determine effectiveness of Physiotherapy-based active-rehabilitation in enhancing ambulatory-outcomes for patients participating NDR.
Methodology :
The study involved patients with NDR in JCIRDC who received Physiotherapy services from 1April2022 to 30September2023. A retrospective-analysis was conducted to compare the length-of-hospital-stay(LOS) in KH for stroke-patients with-or-without future follow-up care at JCIRDC during this captioned period. Modified-Functional-Ambulation-Classification(MFAC) and Modified-Rivermead-Mobility-Index(MRMI) were evaluated by Physiotherapists upon admission-and-discharge at JCIRDC. Tailored-Physiotherapy interventions were provided to the patients, and total-number-of-treatment-sessions at JCIRDC was recorded.
Result & Outcome :
Data from 155 discharged NDR-patients were included. 86.5%(n=134) of patients had experienced a stroke, 2.6%(n=4) had traumatic-brain-injuries, and 11%(n=17) had other-conditions. The average age of the NDR patients was 64.45±13.59 and 45.2%(n=70) were female.
Baseline in-patient admission MFAC were category-III for both groups (p>0.05). The LOS was decreased (a marginal significant) for stroke-patients who would have follow-up care at JCIRDC (27.46±15.51) (n=54) compared to those without follow-up care in JCIRDC (31.73±23.77) (n=452). Providing NDR at JCIRDC after hospital discharge can facilitate early discharge for in-patient stroke cases.
At JCIRDC, the total-number-of-Physiotherapy-sessions delivered to NDR-patient was16.89±9.31. NDR-patients showed a significant improvement in MFAC, with a median progression of one-category from admission MFAC Category V to VI upon discharge(p≤0.05). There was significant improvement in the MRMI scores from admission 28.23±9.74 to 31.14±9.32 at discharge (p≤0.05). Upon complete the training in JCIRDC, 74.5%(n=115) of NDR-patients were able to walk under supervision or independently and 53.7% achieved the ability to walk independently. This outcome held utmost importance on community reintegration, particularly for young patients who have intentions of returning to work. The ability to walk independently is crucial in facilitating their reintegration into the workforce and maintaining ambulatory independence in their daily lives.
Overall, NDR in JCIRDC can facilitate early-discharge for in-patient stroke cases in KH. Significant improvements were shown on the independence in ambulation among NDR patients following Physiotherapy in JCIRDC.
