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Engaging Medical and Rehabilitation Support for TWGHs Wong Cho Tong Enhanced Home & Community Care Services : the KWH Experience Dr. Lorna Ng, SMO, Dept.

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Presentation on theme: "Engaging Medical and Rehabilitation Support for TWGHs Wong Cho Tong Enhanced Home & Community Care Services : the KWH Experience Dr. Lorna Ng, SMO, Dept."— Presentation transcript:

1 Engaging Medical and Rehabilitation Support for TWGHs Wong Cho Tong Enhanced Home & Community Care Services : the KWH Experience Dr. Lorna Ng, SMO, Dept of Family Medicine, KWH Dr. M.H.Chan, COS, Department of Medicine & Geriatrics, KWH Ms. Mariana Wong, Superintendent, TWGHs Wong Cho Tong Social Service Building Mr. Eva Liu, Executive Manager, Dept of Allied Health & Community Support, KWH Mr. Lawrence Fung, Department Manager (Physiotherapy), KWH Ms. Florence Lee, Department Manager (Medical Social Service), KWH

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8 Any Best Practice and Service Model?

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15 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Demographics No. of clients seen = 120 Sex : Female = 83 Male = 37 Mean Age = 81 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

16 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Clinic Statistics Total no. of sessions 52 No. of clinic visits per patient < 3 visit = 86  3 visit = 32 Total no. of patient consultations 252 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

17 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Clinic Statistics Referral to other clinical specialties 9 Referral to Allied Health Services 4 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

18 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Clinic Statistics Investigations done 65 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

19 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Health Status Top chronic diseases presenting at clinic visit : CVA 73 Musculoskeletal disease 32 HT 70 Dementia 31 IHD 47 Depression 21 DM COAD 15 Results: FM Clinic - EHCCS (Oct 05 to Jul 06) Total no. of active clinical problems 543 Average no. of active problems per patient 4.6

20 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Physical Status No. of clients dependent in functional mobility 65 No. of clients totally dependent in ADL 9 No. of clients totally dependent in IADL 28 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

21 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Hospital Admission Baseline Period (Oct 04 – Sep 05) Intervention Period (Oct 05 – Jul 06) No. of pat with hosp adm 14 7 No. of hosp adm episode 28 12 Prevalence rate of hosp adm 11.6% 5.8% Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

22 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

23 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Performance Indicator 1 : Fall-related Injuries Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

24 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

25 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

26 Reasons Led to Unplanned Hospital Admission
Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

27 Results: FM Clinic - EHCCS (Oct 05 to Jul 06)
Prevent Unplanned Hospital Admission / Prevent Hospital Admission (Oct 2005-July 2006) Reasons Prevent Hospital Admission Prevent Unplanned Hospital Admission Total Chest infection and other respiratory problems 5 4 9 Stroke & neurological problems 2 Cardio-vascular problems 3 1 Urinary tract infection 8 GI illness (eg. Diarrhea/GI bleeding) Arthritis/non-injury musculoskeletal illness Other infection/sepsis Fall-related injuries 22 7 29 Total consultations for acute problems: 132 Prevent hospital admissions/unplanned hospital admissions: 22% Results: FM Clinic - EHCCS (Oct 05 to Jul 06)

28 Success Factor: Community Engagement Without lines

29 Thank You!!


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