Allied health led post‐operative hand clinic: Evaluation of an alternative model of care

Abstract

Introduction To assist with the increasing orthopaedic workload, an allied health led hand therapy clinic was established to manage people having routine hand surgeries. The aim of this study was to evaluate patient and doctor satisfaction and safety of this alternative service delivery model. Methods Prospective multimethod design evaluation was undertaken by occupational therapists and physiotherapists working in the field of hand therapy. Satisfaction surveys were completed by orthopaedic doctors and patients. Patient outcomes were assessed at 6 weeks post operatively using the Quick Disability of Arm, Shoulder and Hand questionnaire, total active range of motion, Crawford Classification, sensation using light touch and pain with activity utilising Wong Baker FACES® Pain Rating Scale. Quantitative satisfaction survey data were analysed and presented as frequencies and percentages with open question responses analysed using a qualitative description approach. All complications and readmissions within a 3‐month period were identified and recorded to assess safety of this model of care. Results For the 6‐week post‐operative review, 81 patients were seen by an allied health professional rather than a doctor. Patient satisfaction was high with 90% of patients satisfied with post‐operative care provided by allied health; 2% of patients preferred to be seen by a doctor. Doctor satisfaction was also high with 95% of doctors being satisfied and confident with the quality of care provided. A high proportion of patients reported pain 2/10 or less with activity (82.72%), had full sensation (69.14%), excellent range of motion (82.72%), and Quick Disability Arm, Shoulder and Hand scores on average were below 25% indicating minimal functional deficits. Only five patients required doctor involvement post‐operatively. Conclusion The allied heath led service delivery model was demonstrated to be safe and have high patient and doctor satisfaction, indicating an acceptable alternate pathway for management of people following routine hand surgery.

Effectiveness of occupational therapy interventions on function and occupational performance among adults with conditions of the hand, wrist, and forearm: A systematic review and meta‐analysis

“…Occupational therapists are well placed to provide comprehensive therapeutic intervention as outlined within current standards of care for those with a hand, wrist, or forearm condition. A growing body of evidence supports occupational therapy led hand therapy clinics as being cost effective, enabling specialised early intervention, reducing waiting times, and reducing surgeon workload (Cox et al, 2020; Ellis & Kersten, 2002; O'Donnell et al, 2023; Peck et al, 2001; Peck & Turner, 2013; Sobb et al, 2022).…”