Authors (including presenting author) :
Chow LY Dorothy (1), Lam SK Tommy (2), Tsang TW Ray (1), Chan WY Jenny (1), Fong ON Hannah (1), Chan SY Sherlotte (1), Leung LY Tiffany (1), Chong SH Vincent (1), Chu YT Kiki (1), Ng KT Jasper (1), LY YF Connie (1), Kwan WS Aggie (1), Tse CW Eric (1), Mak MY Mandy (1), Lau CL Terry (2)
Affiliation :
(1)Physiotherapy Department, Tuen Mun Hospital, New Territories West Cluster, Hospital Authority
(2)Accident and Emergency Department Tuen Mun Hospital, New Territories West Cluster, Hospital Authority
Introduction :
Musculoskeletal pain was a common condition for patients to attend Accident and Emergency Department in Tuen Mun Hospital (TMH). Patients presenting with musculoskeletal pain and stable vital signs are classified under categories 3-5 in the triage system. To minimize admission of the above cases, onsite physiotherapy service is introduced on weekdays.
Objectives :
To review the effectiveness of onsite physiotherapy service on admission rate through AED.
Methodology :
This was a retrospective study. Patients of category 3 – 5 with musculoskeletal pain symptoms referred from AED for onsite service were included. Outcome indicators includes:
-Pain level measured by Numeric Pain Rating Scale (NPRS)
-Discharge destination
Result & Outcome :
Total number of 770 patients were referred for onsite physiotherapy service from AED on weekdays from Jan 2020 to Sep 2023. Mean age was 60.01(±SD 18.0). 443 patients were back pain condition (58%), while 195 patients (25%) and 132 patients (17%) were lower limb and other joint pain condition respectively.
The overall mean pain level for musculoskeletal condition significantly decreased from 6.88 to 4.96 (p<0.05), while the pain level for back pain significantly decreased from 6.98 to 4.96 (p<0.05). 191 patients (25%) required admission, with mean pain level 6.49 upon discharge from onsite physiotherapy service. 579 patients (75%) did not require admission. Among those case, 335 patients (58%) were referred for physiotherapy outpatient or community physiotherapy follow-up. This program estimated to have saved approximately 1,700 patient-bed-days.
Hence, the implementation of early onsite physiotherapy services within the AED has demonstrated efficacy in mitigating pain and decreasing hospital admissions for musculoskeletal pain on weekdays. It is advisable to consider the expansion of this program to encompass weekends and public holidays, contingent upon the availability of adequate staffing resources.
