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5-6 December 2005 - Melbourne

ANCER Unit (Acute Neurological Care, Elderly Rehab) Presenter: Josie Kitch Hospital: Centauri Key contact person for this project: Julie Luker, AH Team Leader, ANCER Unit, julie.luker@fmc.sa.gov.au. 5-6 December 2005 - Melbourne. KEY PROBLEMS.

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5-6 December 2005 - Melbourne

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  1. ANCER Unit (Acute Neurological Care, Elderly Rehab)Presenter: Josie KitchHospital: CentauriKey contact person for this project: Julie Luker, AH Team Leader, ANCER Unit, julie.luker@fmc.sa.gov.au 5-6 December 2005 - Melbourne

  2. KEY PROBLEMS • Long stay project (Sept 02) identified that these patients have mobility disability, have been through ICU, deconditioned, falls, CVA and geriatric syndromes • Aims to set up a clinical system that provides an alternative style of acute hospital care that is rehab in style • Moving out of FMC is still highest priority so close liaison with transition services (rehab, RITHOM, ATA,SDC,ACAT, MHL)

  3. HOW WE DID IT • Project Started: October 2003 • Staffing: 4.6 FTE current staffing. 11.9FTE new staffing (professional and ops staff) • Funding: Staffing came from combination of staffing previously covering Neuro wards and new monies • Duration: Ongoing

  4. INNOVATIONS IMPLEMENTED • Outcomes: • Mortality – Stroke • Pre-ANCER 20% • Post-ANCER 11.85% (Australian Benchmark 10%) • LOS – Stroke • Pre-ANCER 9.99 • Post-ANCER 14.9 days

  5. OUTCOMES SO FAR • Discharge destinations • 76.3% discharged directly home • 10.2% transferred to RGH Rehab with view to discharge • 7.8% HLC placement • Pre-ANCER – 57% home, 22% rehab and 12% to nursing home

  6. Outcomes so far • Functional change during ANCER admission (FIM + FAM scores) • Average across all admission times: • Selfcare – 7.0 points • Swallow – 0.1 points • Bladder control – 0.6 points • Bowel control – 0.4 points • Mobility/locomotion – 7.0 points • Communication – 0.3 points • Psychosocial – 0.8 points • Cognition – 0.9 points • Overall Score change – 18.8 points

  7. LESSONS LEARNT • Needed to do significant work with Nursing staff to clarify the role of rehab in the acute setting • Difficulty with Nursing recruitment due to the “heavy” nature of the ward – need to sell rehab • Having an AH Team leader has been invaluable to drive service development • Do differently – start all staff at same time – AH team established prior to Nursing and was a “threatening” environment to come into • Clear medical leadership and medical responsibility as this is still unresolved • Clarification of the role of acute rehab with all

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