Authors (including presenting author) :
Fung PM
Affiliation :
Department of Orthopaedics & Traumatology, the Duchess of Kent Children's Hospital at Sandy Bay
Introduction :
In current situation in DKCH Joint Clinic, traditional face-to-face consultation are becoming unmanageable due to increasing number of attendance in joint replacement, leading to 83.3% of clinic overruns from first quarter of 2024 and potentially decreased patient satisfaction. Total number of attendance in joint replacement shows an increasing trend annually from 805 cases in 2017 and will be projected to 1870 cases at the end of 2024. With each doctor seeing 21.7 patients on average in a half-day session, there is a clear need for alternative care delivery methods. Besides, most importantly, Hospital Authority has been actively promoting further expansion of telehealth services in various healthcare settings. In coherence to the current change of era, extensive use of telehealth as consultation will be the trend.
Objectives :
1. To increase number of telehealth attendance to at least 5% of overall nurse clinic attendance 2. To reduce the number of patients per doctor in each session, thereby minimizing clinic overrun to below 40%. 3. To achieve patient satisfaction rating of 85% or higher for telehealth consultation. 4. To ensure Knee Society Knee Score and Knee Society Functional Score are comparable to traditional in-person follow-ups.
Methodology :
This project proposes migrating stable cases to nurse-led telehealth consultations for post-operative knee replacement patients. Nurses can fully utilize the function of IMSN to recruit more cases to nurse clinic and conduct virtual follow-ups, assess recovery progress, and address patient concerns, thereby reducing the number of patients seen by doctors in person.
Result & Outcome :
To implement and evaluate Telehealth in joint nurse clinic for follow-up of stable joint replacement patients, aiming to enhance patient access to care, improve clinic efficiency by reducing overruns and doctor workloads, and maintain high levels of patient satisfaction. The average number of telehealth cases after implementation increased from 0.3 cases to 18.4 cases per month. These contributed to a significant reduction in clinic overrun times from 83.3% to 28.6% and improved doctor-to-patient ratios from 1:21.7 to 1:14. Patient satisfaction surveys indicated high levels of satisfaction with nurse clinic and telehealth follow-ups. 100% of patients rated "agree" or above from all questions and 100% of patients rated “strongly agree” from the following statements: Confident with nursing staff, satisfy with nursing care plan, and overall service satisfaction. Knee Society Knee Score and Functional Score were collected. Both scores in pre- and post-intervention groups were similar without statistically significant relations (p>0.05). It revealed that, clinical outcomes were comparable to those achieved through traditional in-person follow-ups.
