Rapid access to hand therapy services in the emergency department: beginning the journey for implementing alternate pathways of care
Meagan Gough1, Kate McLaughlin1, Kylie Bebel 1, Sandra Hookins1, Amber Jones 1, Hannah Gullo2 1The Prince Charles Hospital, Brisbane, Queensland, Australia2School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
Abstract
Background. Rapid access models of care have been introduced within Queensland Health to optimise care provision and efficiency. An expanded scope, rapid access hand therapy service, delivered by advanced occupational therapists, has been integrated in the emergency department to provide patients with alternative, patient centred pathways to optimise flow. The service provides same day screening, diagnosis and treatment for hand and upper limb injuries, and a rapid access pathway to prevent unnecessary fracture clinic referrals. Method. A program logic model has informed service planning and implementation. A mixed-methods approach, embedded within the Metro North Health Evaluation Framework, will be undertaken to evaluate the model of care across reach, effectiveness and impact, implementation, patient experience and sustainability domains. Preliminary analysis of demand, pathway effectiveness and patient satisfaction has been undertaken. Results. Fifty-four patients have accessed the service in the initial two months with an activity trajectory reflecting increasing demand. Operationalisation of clinical pathways and rapid access to hand therapy has prevented unnecessary referrals to fracture clinic for non-surgical hand fractures. Patient reported experience measures show 100% of responders reported a “very good” experience with the service, and “would recommend the service to others”. Discussion. Early indicators point to the positive impact of this innovative service approach and full scope utilisation of hand therapy as a highly valued alternative model. Further implementation will enable ongoing data collection to build on these findings and may demonstrate effective and sustainable implementation. Results may support the implementation of this rapid access service in other jurisdictions.
Biography
Kylie Bebel is a Senior Occupational Therapist and Accredited Hand Therapist as awarded by The Australian Hand Therapy Association. Kylie has delivered hand and upper limb services, in public and private settings, in Australia and London, before moving to The Prince Charles Hospital 11 years ago.