Page 212 - Hospital Authority Convention 2018

Service Enhancement Presentations
HOSPITAL AUTHORITY CONVENTION 2018

F6.5 Enhancing Partnership with Patients and Community 10:45 Room 421

Breaking Down Work Silos between Hospital and Community
Medical Social Collaboration for Management of Work Related Low Back Pain
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Law SW , Chau WW , Ko SY ,Fay S3 Department of Orthopaedics and Traumatology, Tai Po Hospital, Department of
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Orthopaedics and Traumatology, The Chinese University of Hong Kong, Association for the Rights of Industrial Accident
Victims, Hong Kong
Introduction
Work related low back injuries with pain is notoriously difficult to manage because of complex interplay between biological,
psychological and social factors. In addition to medical problem, patient with work related low back pain is facing problem
of liaison with employer for return to work, compensation, work settlement. These are considered as service gap of hospital-
based service. Work rehabilitation in silo without community parties’ input results in discontinuation of care, work disability
and chronic pain.
To tackle this long standing problem. A Medical-social Collaboration (MSC) platform facilitating co-joined work rehabilitation
service with input from social worker, was established since 2015 in Orthopaedic Ambulatory Care Centre. In addition to
medical intervention, there is onsite counselling including psychological support, social support, experience sharing on
handling of workers compensation for every clinic session from ARIAV .

Objective
To evaluate the outcome of MSC care model with respect to return-to-work rate and functional outcome.
Methodology
80 patients with work related low back pain on sick leave recruited (2015-2017) from the Specialist Outpatient Clinic waiting
list which enrolled into the MSC programme was reviewed prospectively.
Results
59% of patients return to work within one year. Total number of sick leave days was 261.9. All of them attended counselling
session on handling procedures of work injury. 74.6% and 60.3% of them received psychological support and consultation
on legal issue respectively. 42.9% of them were offered employment counseling and job re-training courses for patient
reintegration into society.

For functional restoration, significant improvement was shown in Roland Morris Disability Questionnaire mean score which
was decreased from 16.09 to 11.82 (p value <0.01).

Our result reviewed that MSC model in work rehabilitation is feasible, this will be a potential solution to bridge the service gap
of hospital-based service. Breaking down the work silo requires co-joined effort and communication to design a bio-psycho-
social care model for transition of care. The effort is worthwhile to provide a comprehensive work rehabilitation that puts
injured worker’s benefits first.
Tuesday, 8 May 2018

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