Authors (including presenting author) :
Chan WL (1), Chan WY (1), Chui PF (1), So TWP (1)
Affiliation :
(1) Occupational Therapy Department, North Lantau Hospital
Introduction :
Since 2019, Fall Prevention Program (FPP) has been provided to elderly patients with fall risks in Emergency Medicine Ward (EMW) of North Lantau Hospital. FPP includes multi-dimensional assessments and needs-specific interventions. However, the insufficient coverage of pre-discharge home environment assessments due to time consumed in long distance travelling in Lantau district prompted the introduction of telehealth technology in July 2024. This initiative composed of pre-discharge “Tele home visits (TCOT)” and streamlined post-discharge follow-up via Occupational Therapy outpatient service. Through virtual visit, the safety of patient’s home environment was assessed and personalized fall prevention strategies were provided to caregivers in order to speed up necessary rectifications before discharge. The need for outpatient follow-up was also triaged with reference to information obtained during TCOT.
Objectives :
To review the effectiveness of pre-discharge TCOT in promoting safe discharge for fall-risk patients in a pilot trial.
Methodology :
Those patients in EMW who referred to Occupational Therapists for fall assessments and matched pre-determined criteria (fall history within last six months and significant decline in functional or cognitive performance) were enrolled in FPP. High-risk patients were offered pre-discharge TCOT via HA GO. In post-discharge phase, patient’s needs were triaged follow by specific outpatient interventions including onsite home visits, functional and cognitive rehabilitation.
Result & Outcome :
From July to December 2024, 178 patients were recruited in FPP, with 155 eventually returned home. Among them, one-fourth of 24 patients indicated for early post-discharge home visit could be successfully engaged in pre-discharge TCOT. Pre-discharge TCOT recipients had an average of 4.1 fall hazards identified in their homes, compared to 5.7 in those without TCOT. The relatively lower in number of hazards were mainly due to the timely implementation of risk reduction strategies provided during pre-discharge TCOT that exemplify the benefit of this new initiative. A preliminary conclusion is drawn that pre-discharge TCOT is an effective and feasible means for Occupational Therapists to identify fall risk in patient ‘s home environment. The telehealth technology helps to conserve travelling time spend in Lantau district, increase coverage of patient-in-need of home visit and provide a more valid way of triage for post-discharge outpatient services. Telehealth is believed to unleash more its potential benefit among the elderly population by educating caregivers about the importance of pre-discharge home visit (TCOT), providing a more user-friendly software interface and improving the readiness of hardware setup in patient’s own home/ nearby community.
