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Reducing Rehab Waiting Times

Reducing Rehab Waiting Times. A/Prof Stephen Wilson Royal North Shore Hospital. Key Problem. Problem: Long Rehab wait due to “Iatrogenic disability” causing increased length of stay in hospital Factors: Structure of a combined Aged Care and Rehab Dept

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Reducing Rehab Waiting Times

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  1. Reducing Rehab Waiting Times A/Prof Stephen Wilson Royal North Shore Hospital

  2. Key Problem • Problem: Long Rehab wait due to “Iatrogenic disability” causing increased length of stay in hospital • Factors: Structure of a combined Aged Care and Rehab Dept Focus on medical vs functional issues Poorly organised Rehab consulting service Governance, leadership, responsibility, accountability, data Staffing • Drivers: Quality and Activity Based funding

  3. Aim of the Innovation • The aim of this project was to develop and explore interventions to reduce waiting times for sub-acute rehabilitation patients in acute care and free hospital beds (for more appropriate acute care) by: • Reducing wait times for transfer to Bed Based sub acute Rehab –improve flow • Increasing referral and uptake of non bed based options eg Home Based Rehab, Transitional Aged Care, Community Care (COMPACKS)

  4. Baseline Indicators • Acute hospital Indicators: ALOS 2010/11 was 7.99 days for Rehab Type change episode ALOS 2010/11 waiting for transfer was 4.91 Days retrieved from Patient Access Transport Unit

  5. Key Changes Implemented Innovations Model • Establish Rehabilitation Department 2011 • Patient flow Model developed • Developed acute in-reach (SMART) and Renal Rehabilitation for stay > 7 days • Rehab part of Multi Disciplinary Team meetings • Website portal for rehab options and referral process • Ensure appropriate and timely rehab type change • Single point of referral for rehab

  6. OUTCOMES SO FAR Changes in patient flow Bed days for patients waiting for transfer • Reduction of patients waiting for transfer from 1690 (10/11) to 968 (11/12) n=722 patients • Reduction of bed days waiting from 8263 to 4384 (save 3879 bed days) • Transitional Aged care 27 (10/11) to 47 (11/12) • Community Package 465 (10/11) to 513 (11/12)

  7. LESSONS LEARNT • Governance • Communication • Multidisciplinary Team vs Single Discipline assessment • It is possible to Map > Model > Direct Traffic from bed based to non bed based services

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