Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Chu SY(1), Leung PY(1), Lui NF(1), Poon TL(2), Man KL(2), Chang MY(2), Leung SM(2), Mak HK(2)
Affiliation :
(1) Occupational Therapy Department, Queen Elizabeth Hospital (2) Department of Neurosurgery, Queen Elizabeth Hospital
Introduction :
Fall is a leading cause of traumatic head injury (TBI) among elderly. It reduces ones’ functional independence, community participation and negatively impacts the quality of life. In 2021, the Department of Neurosurgery of Queen Elizabeth Hospital introduced a multi-disciplinary Extended Care Program (ECP) for TBI patients to facilitate an early and safe discharge and to reduce re-admission. The Occupational Therapist delivers fall prevention program by means of post-discharge home visit and TeleHealth follow up. Advanced technology application is incorporated into fall risk assessment in the program.
Objectives :
This paper is to review the feasibility of technology utilization in fall prevention of TBI patients.
Methodology :
Patients aged over 65 with fall history were screened and recruited to ECP during in-patient period. The occupational therapist offered 2-3 home visits within 1 month upon discharge. Aspire Balance sensor, a technological fall risk assessment device, was applied as a screening tool and triaged fall risk groups in the initial assessment. Fall prevention interventions, including home safety assessment and modification, assistive device prescription, home program of activities of daily living (ADL) and instrumental ADL (IADL) training; and fall prevention education, were tailor-made according to the triaged result. Modified Barthel Index (MBI), Lawton IADL scale and Fall Efficacy Scale (FES) were served as the outcome measures of the performances of ADL, IADL and fear of fall representatively. Outcome measures were compared before and after the program to elevate the program’s effectiveness.
Result & Outcome :
From 2021 to present, 60 patients were recruited to the ECP. 29 patients were triaged as high fall risk by the Aspire Balance sensor, which 93.1% of them found to have at least 1 fall history within 1 year. The result was compatible with the traditional fall risk screening. The mean score improved from 81.66 to 85.97 in MBI; from 9.10 to 10.82 in Lawton IADL scale and from 66.25 to 82.58 in FES after intervention. Significant difference was shown in pre- and post-intervention in MBI, Lawton IADL scale and FES (p=0.004, p=0.048 and p=0.021 representatively; p<0.05). It implied that the triaged high fall risk patient group improved in ADL and IADL and reduced fear of fall after the ECP. The advanced technology application demonstrates the comparatively effective on fall risk assessment and fall risk triage on community dwellings. In the future, it can be considered to incorporate this device in fall risk assessment to improve the patient experience and efficiency with consistency in our service provision.
