Authors (including presenting author) :
Pang CY(1), Lam YH(1), Yip HT(1), Lam PL(1), Tsang TC(2)
Affiliation :
(1) Physiotherapy Department, Queen Mary Hospital (2) Department of Accident and Emergency, Queen Mary Hospital
Introduction :
Traditionally, patients in the Accident & Emergency Department (AED) were triaged by nurses into five categories based on clinical needs: Critical, Emergency, Urgent, Semi-urgent, and Non-urgent. Patients with musculoskeletal low back pain (LBP) were subsequently assessed by doctors before referring to physiotherapy. In order to facilitate the management of these patients, a program was initiated for the early assessment of LBP Patients by Physiotherapists at Queen Mary Hospital (QMH) AED. This allows physiotherapists to screen patients in Categories Four and Five for red flag signs and conduct assessments prior to doctor consultations.
Objectives :
To evaluate the effectiveness of the Early Assessment program for LBP patients at AED.
Methodology :
All patients assessed by Physiotherapist in this program between November 2023 and October 2024 were reviewed. Feedback from QMH AED doctors was collected through questionnaires.
Result & Outcome :
87 patients (34 males, 53 females; age was 58.85±18.51) were assessed. Recommendations included 47 patients referring to outpatient physiotherapy, 13 patients received one-off physiotherapy treatment, 19 patients exhibited red flag signs necessitating further investigation, 8 patients were discharged without any physiotherapy service. 91% of the recommendations were agreed by doctors, while the remaining 9% of cases were discharged directly without physiotherapy service which were opposite to physiotherapist’s recommendations. Notably, no patients were readmitted to AED for the same issue within one month. A total of 26 questionnaires were returned from AED doctors. They rated the usefulness of physiotherapist information at an average of 8.5 out of 10 with “10” being most useful, indicating significant support for the program. Doctors found physiotherapist assessments particularly beneficial in facilitating their workflow (77%) and saving their time (73%). 85% of them suggested extending the program to other conditions like knee, shoulder, and neck pain.
Discussion and Conclusion: The Early Assessment program proved safe and effective, with physiotherapist recommendations well-received by doctors. The initiative not only facilitated better management of LBP patients but also opened avenues for inclusion of additional musculoskeletal conditions in future assessments. The positive feedback highlights the potential for physiotherapy to enhance patient care in emergency settings.
