Occupational MedicineCare Service

a local experienceDr Fok JPC, Dr Kung KKL, Ms Cheung CCM,

Mr Lee EWC, Prof Yu ITS, Dr Lam AT, Prof Li PKT

Innovating models of care and modern health system II – SPP 8.1

Background

no

year

2002 2003

703

761

732 729

773

660

680

700

720

740

760

780

no of IOD

02 03 04 05 06

in NTEC

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.

Injured staffInjured staff

AED, Staff Clinic, GOPCAED, Staff Clinic, GOPC

PrivateSector

PrivateSector

Manage within own settingRefer if no progress

Manage within own settingRefer if no progress

Specialist clinicSpecialist clinic

RehabilitationRehabilitation

Workplace

Long waiting time`̀Prolonged sicknessReduced fitnessProlonged sicknessReduced fitness

Usual Care for IOD before OMCS

OSHOSH

Injured staffInjured staff

AED, Staff Clinic, GOPCAED, Staff Clinic, GOPC

PrivateSector

PrivateSector

RehabilitationRehabilitation

Workplace Prevent injuries

Occupational MedicineCare Service

Occupational MedicineCare Service Dedicated team of:

1. Doctors2. Care managers3. Physiotherapist4. Occupational

Therapist5. Clinical

psychologist

Early intervention

Other SpecialistsOther Specialists

Human ResourceHuman ResourceSupervisors, peersSupervisors, peers

OSHOSH

Multi-disciplinary care for IOD after OMCS

Occupational MedicineCare Service

Occupational MedicineCare Service

TeamworkService DirectorService Director

Clinical LeaderClinical Leader

Care ManagersCare Managers OM DoctorsOM Doctors

OM Hon. ConsultantOM Hon. Consultant Steering CommitteeSteering Committee

Human Resources ManagerOSH ManagerPhysiotherapy DMOccupational Therapy DMCND Senior Nursing Officer Risk Management Manager

Human Resources ManagerOSH ManagerPhysiotherapy DMOccupational Therapy DMCND Senior Nursing Officer Risk Management Manager

Staff-focused

Care managersCare managers

Doctors &TherapistsDoctors &Therapists

Proactively contact all IOD staff within 3 daysProactively contact all IOD staff within 3 days

Clinic appt within 3 days, allied health appt within 1 week.

Clinic appt within 3 days, allied health appt within 1 week.

Family

Workplace

Supervisors

Peers

Strategies of OMCS

• Tailor - made rehabilitation plans• Empathic counselling• Workplace visits• Trustful coordination with staff, peers and

supervisors

Group Discussion/Sharing員工討論/分享

Group Discussion/Sharing員工討論/分享

Demonstration示範

Demonstration示範

Education訓練

Education訓練

Task analysisTask analysis

Prevention of InjuryPrevention of Injury

To foster a safe and caring workplace

0

40

80

120

160

200

Contus

ionSpra

in & st

rain

Back i

njury

Abrasio

n

Frac

ture

Falls

773 IOD in 2006[out of 8,000 staff]

Results

Results

342352

386

367

323

280

300

320

340

360

380

400

2002 2003 2004 2005 2006

↓12%↓12%

Contusion, sprains and strains comprise 70% of IODsContusion, sprains and strains comprise 70% of IODs

(p=0.01)

no of IOD

Results

12.313.5

14.7

10.3 10.1

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

2002 2003 2004 2005 2006

Mean Sick leave days per IODMean Sick leave days per IOD

5.73.2

27.9

13.4

21.2 26.9

64.9

11.59.7 7.2

73.7

87.3

0

20

40

60

80

100

Abrasion Sprain &strain

Backinjury

Fall Contusion Fracture

Type of injury

Past data

OMCS

↓43.9%

Average sickness absence daysAverage sickness absence days

↓52.0%

↓82.2%

↓25.8%

(p<0.05)

(p=0.006)

2002-20052006

Results

Results

188

161142

108

89

0

50

100

150

200

2002 2003 2004 2005 2006

Average sick leave days for those with prolonged absence ≥ 28 daysAverage sick leave days for those with prolonged absence ≥ 28 days

↓18%

(p>0.05)

71

91

0

50

100

OMCS Attendance No OMCS Attendance

p<0.05

Average sick leave days for those with prolonged absence ≥ 28 daysAverage sick leave days for those with prolonged absence ≥ 28 days

Results

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

94% 97%92% 92%

100%

0%

20%

40%

60%

80%

100%

Overallimpression

Providequality care

Efficientservice

Able to carefor

occupationalproblem

OMCS staffattitude

Perc

enta

ge a

vera

ge, s

atis

fied

or v

ery

satis

fied

with

OM

CS

n = 36

0%

20%

40%

60%

80%

100%

• Service recommendation

97% of patients recommend our service to others

97% of patients recommend our service to others

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 TeamOMCS TeamProf 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 !