Page 112 - Hospital Authority Convention 2018

Parallel Sessions
HOSPITAL AUTHORITY CONVENTION 2018

PS4.3 Collaborative Service Programmes 16:15 Room 221

Physiotherapy Restoration Rehabilitation Programme for Lower Limb Fracture and Arthroplasty on Weekends
and Public Holidays – Local Experience Sharing
Wan SSY
Physiotherapy Department, Pamela Youde Nethersole Eastern Hospital, Hong Kong

Introduction
Lower limb fractures especially hip fractures and arthroplasty are the commonest causes of orthopaedic admission.
Current evidence suggested that early mobilisation facilitated rehabilitation and reduced hospital stay. Physiotherapy (PT)
service for lower limb fracture and arthroplasty in acute setting on weekends and public holidays (365-PT Service) has been
implemented in Pamela Youde Nethersole Eastern Hospital (PYNEH) since October 2017 in accordance with the Strategic
Service Framework.

Objectives
To evaluate the status and effect of 365-PT Services in PYNEH.

Methodology
Monday, 7 May 2018 hospital were collected and compared with the data of patients with the same diagnostic group captured in 2015 and 2016.
Patients with hip fracture and arthroplasty admitted to PYNEH from October 2017 to February 2018 and received 365-PT
Service were recruited. Their clinical and service outcomes including Modified Functional Ambulation Classification (MFAC),
Elderly Mobility Scale (EMS), length of hospital stay (LOS) in PYNEH and their discharge destinations from convalescent

Results
From October 2017 to February 2018, 1,007 patients received the 365-PT Services (on 19 Saturdays and 31 Sundays/Public
Holidays). 60% of them were post-operative hip fracture cases, 24% of them were patients with arthroplasty and the rest
16% were post-operatively cases of other lower limb fractures. For those cases with post-operative hip fractures, their
average LOS_PY (7.1 days) were decreased when compared with those in 2015 (9.1 days) and 2016 (8.7 days). And there were
no significant differences in the MFAC and EMS on discharge to convalescent hospital for further rehabilitation. Following
through their discharge destination after convalescent hospital stay, the “discharge to patient’s home” proportion was higher
after 365-PT Service (65%) as compared with 2015 (55%) and 2016 (55%).

Conclusions
Decrease in LOS was found in this patient group after implementation of 365-PT Service. With shorter hospital stay, those
patients achieved similar clinical outcomes earlier before transfer to convalescent hospital. There were higher proportion
of patients who lived home prior to admission to be discharged to their original destination after rehabilitation. Aligned with
current studies, this 365-days active physiotherapy intervention facilitates earlier discharge of patient in acute setting and in
the long run may have better functional outcome as reflected in higher rate of home-discharge.

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