Innovating models of care and modern health system II SPP 8.1 Occupational Medicine Care Service a local experience Dr Fok JPC, Dr Kung KKL, Ms Cheung CCM, Mr Lee EWC, Prof Yu ITS, Dr Lam AT, Prof Li PKT
Background no 780 761 773 760 740 732 729 no of IOD in NTEC 720 700 703 680 660 2002 02 2003 03 04 05 06 year
Consequences of Injury-on-duty ( IOD ) in HA staff : Double loss Impact on the workplace Impact on the staff and his family Impact on population health in HK Medico-legal issues
Background People First Care for the Carers A staff-focused initiative NTEC selected as one of three pilot clusters for Occupational Medicine Care Service in end of 2005.
Objectives: 1. prompt management and rehabilitation for staff injured on duty ( IOD ). 2. timely re-integration of the injured staff into the workplace, either the original department or other alternative job nature. 3. foster a caring and safe workplace.
Usual Care for IOD before OMCS OSH Workplace Injured staff AED, Staff Clinic, GOPC Private Sector Manage within own setting Refer if if no no progress Prolonged sickness Reduced fitness `` Specialist clinic Long waiting time Rehabilitation
Multi-disciplinary care for IOD after OMCS OSH Workplace Occupational Medicine Care Service Injured staff Prevent injuries AED, Staff Clinic, GOPC Early intervention Private Sector Other Specialists Occupational Medicine Care Service Rehabilitation Supervisors, peers Human Resource Dedicated team of: 1. Doctors 2. Care managers 3. Physiotherapist 4. Occupational Therapist 5. Clinical psychologist
Teamwork Service Director OM Hon. Consultant Clinical Leader Steering Committee Care Managers OM Doctors Human Resources Manager OSH Manager Physiotherapy DM Occupational Therapy DM CND Senior Nursing Officer Risk Management Manager
Staff-focused Workplace Peers Supervisors Care managers Proactively contact all IOD staff within 3 days Family Doctors & Therapists Clinic appt within 3 days, allied health appt within 1 week.
Strategies of OMCS Tailor - made rehabilitation plans Empathic counselling Workplace visits Trustful coordination with staff, peers and supervisors
Prevention of Injury Task analysis Group Discussion/Sharing 員工討論 / 分享 Education 訓練 Demonstration 示範
To foster a safe and caring workplace
Fracture Falls Back injury Abrasion Sprain & strain 200 160 120 80 40 0 Results 773 IOD in 2006 [out of 8,000 staff] Contusion
Results Contusion, sprains and strains comprise 70% of IODs no of IOD 400 386 380 360 342 352 367 12% (p=0.01) 340 323 320 300 280 2002 2003 2004 2005 2006
Results Mean Sick leave days per IOD 16.0 14.0 12.0 10.0 8.0 6.0 4.0 2.0 0.0 14.7 12.3 13.5 10.3 10.1 2002 2003 2004 2005 2006
Results Average sickness absence days 100 80 60 Past data OMCS 2002-2005 2006 (p<0.05) 64.9 (p=0.006) 82.2% 73.7 87.3 40 43.9% 27.9 52.0% 21.2 26.9 25.8% 20 5.7 3.2 13.4 11.5 9.7 7.2 0 Abrasion Sprain & strain Back injury Fall Contusion Fracture Type of injury
Results Average sick leave days for those with prolonged absence 28 days 200 188 18% 150 161 142 (p>0.05) 100 108 89 50 0 2002 2003 2004 2005 2006
Results Average sick leave days for those with prolonged absence 28 days 100 71 p<0.05 91 50 0 OMCS Attendance No OMCS Attendance
Results In 2006, 91% ( n = 702 ) injured staff with sick leave given returned to work within 28 days from day of incident. 100 % coverage of IOD by care managers. The no of OMCS clinic attendance increased from 88 to 162 in the first to last quarter of 2006.
Patient satisfaction survey in May, 06 100% 94% 97% 92% 92% 100% Percentage average, satisfied or very satisfied with OMCS 80% 60% 40% 20% 0% Overall impression Provide quality care Efficient service Able to care for occupational problem OMCS staff attitude n = 36
Service recommendation 100% 80% 60% 97% of patients recommend our service to others 40% 20% 0%
Conclusion OMCS is a new proactive model of care for the carers through multi-disciplinary concerted effort with a staff-focused and workplace re-integration approach. Encouraging results in staff satisfaction survey and increasing OMCS clinic attendances.
Conclusion Significant reduction in contusion, sprain and strain IOD incidences from 2005 ( n = 367 ) to 2006 ( n = 323 ) ( p = 0.01). When comparing the mean sickness absence days in 2006 and past 4 years average, significant difference seen in sprain and strain ( 13.4 days vs. 27.9 days, p < 0.05 ) and fall ( 11.5 days vs. 64.9 days, p = 0.006 ).
Conclusion For those with prolonged sickness absence 28 days, there was a significant difference in SL days in those who attended OMCS clinic ( 71 days) and those who did not ( 91 days) ( p < 0.05 ).
OMCS Team Prof Philip Li SD (C, CS & P) Dr. Tsan Lam COS (FM) Prof Tak Sun Yu Prof (Comm & FM) Dr Pui Chu Joan Fok MO Dr Kenny Kung Resident Ms Chi Man Cynthia Cheung NO Mr Wai Chi Edwin Lee SPT Ms Pauline Lo CC (OSH) Mr Herman Lau CC (PT) Mr Peter Leung SHRM (HR) Mr Frederick Au DM (Occup) Ms Frances Louie DM (Occup) Ms Jane Liu DOM (surgery) Ms Becky Ho SNO (RM&PR) Ms Christine Leung DOM (FM&GOPC) Ms Kitty Ma AHRM (HR) Ms Peony Yu GSA (clerk) Ms Shao Tao Lily Yu GSA (PC)
Thank You!