Effects of a Telehealth Home Care Program in St. John Hospital

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Abstract Description
Submission ID :
HAC571
Submission Type
Authors (including presenting author) :
Mak MY(1), Law KY(2), Cheung CP(2), Lan YH(2), Po Y(1), Mok LC(3), Wong M(1)
Affiliation :
(1)Community Healthcare Services, Hong Kong East Cluster, (2)Community Nursing Services, St. John Hospital, (3)Nursing Services Department, Hong Kong East Cluster
Introduction :
Advances in Telehealth Technology have greatly enhanced the effective management of pressure injuries (PI), particularly for patients away from urban areas. The Community Nursing Services (CNS) at St. John Hospital (SJH) handles approximately 4,000 wound care cases annually, with over 70% involving PI in the elderly. To more effectively assess the impact of telehealth on patients with PI, we integrated telehealth technology at Cheung Chau community through SJH's Evidence-based wound management program.
Objectives :
This study examined the impact of managing PI via telehealth on wound area reduction and overall healthcare utilization, including CNS home visits, accident and emergency department (AED) visits, and unplanned hospital admissions due to wound complications.
Methodology :
Participants had to be over 18 years old, home bounded and residing in Cheung Chau who have stage 2 or above PI under SJH CNS wound management. Patient or main caregiver with AMT ≥ 6 and able to give consent or minor consent would be recruited. Of those with unstable PI, poor physical conditions, or unable to access telehealth services would be excluded. Each participant received five sessions of a one-hour home-based educational program covering wound assessment and dressing techniques. Community Nurses (CN) assessed their knowledge and skills upon completion of the program. Participants took an active role in daily wound care with their knowledge and skills reinforced during each CNS tele-visit. CN continuously monitored wound conditions from daily to weekly through home visits. The average ratio of home visits to tele-visits was 3:1. Wound areas were measured objectively using a 3D method. Data on healthcare utilization was retrospectively drawn from the Clinical Management System (CMS).
Result & Outcome :
A total of 7 eligible participants were recruited in October 2024, and 6 were followed for eight weeks. In a two-month comparison, the mean wound area was reduced by 45.7%. The CNS attendance per headcount ratio significantly decreased by 41% (p=0.004), with no patients visiting the AED for wound issues 100% (p=0.17), and no unplanned hospitalizations due to wound problems, a decrease of 100% (p=0.36). Applying Poisson probability distribution, based on the average utilization of 0.15 during the two-month pre-intervention period, the probability of overall healthcare utilization for this patient group in the following 6 months was estimated at 0.061. Conclusion: The reduction in overall healthcare utilization and wound area indicates that this program can provide significant cost savings for PI management and offers a new service model for community nursing. It is hoped that the outcomes of this study will open a new chapter for future SJH community nursing programs, enhancing the capacity to meet increasing service demands.
Nurse Consultant (Community) 
,
Hong Kong East Cluster And Pamela Youde Nethersole Eastern Hospital
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