Proposed Topic (Most preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Wong HL (1), Tang WS (1), Fan CC(1), Li LV(1)
Affiliation :
(1)Physiotherapy Department, Yan Chai Hospital
Introduction :
Fracture cases with casts, pops, or immobilizers are often considered as lower priority (P2) despite the urgent need for physiotherapy treatment. However, potential complications arising from immobilization, such as inadequate care, lack of awareness regarding surgical wounds, cast fitness, skin condition, and proper weight-bearing status, are frequently underestimated. To address these challenges, the Fast-track Fracture Clinic program offers expedited and comprehensive services, emphasizing prompt treatment and early intervention to minimize complications and promote healing. Additionally, for non-weight-bearing or partial weight-bearing cases discharged from in-patient care, the program provides same-day outpatient service to overcome travelling or walking difficulties. TeleHealth integration facilitates home-based rehabilitation, enabling remote monitoring and reducing travel inconvenience. Through this innovative program, fracture patients receive timely and holistic care, ensuring optimal outcomes and improved patient experience.
Objectives :
To establish an expedited physiotherapy outpatient service for patients with fracture, ensuring prompt treatment within a week. For patients who are still on cast, immobilizer or non-weight-bearing status, they are prioritized as P1 instead of P2 cases. In addition, the patients’ progression is supplemented with TeleHealth to reduce travel inconvenience in selected individuals, enabling home-based exercise with self-management. Also, with early intervention, this new service mode of fracture clinic aims to reduce potential complications, encourage self-management and boost up bone healing.
Methodology :
Waiting time for the first physiotherapy outpatient session in fracture cases is measured. Indicated cases are provided with 2-3 times qualified physiotherapy sessions a week for bone healing promotion. Number and quality of Telehealth sessions, taking into account patient satisfaction and any potential complications.
Result & Outcome :
A total of 75 patients with fractures are recruited in this new fracture clinic in 3 months. They are seen within one week, or even the same day as their referral submission if indicated. The waiting time has been significantly reduced, and patients are educated with proper mobilization, walking exercises and self-management techniques. For those non-union fractures, bone healing is promoted and enables faster rehabilitation. Complications such as stiffness of other uninvolved joints and potential risk of fracture dislocation due to improper mobilization are avoided. Besides, with addition of TeleHealth, patients’ progress of home exercise and self-management are safely monitored while reducing travelling inconvenience, particularly for patients who require non-weight bearing walking.
