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Hospital Royal North Shore

Innovation Poster Session HRT1215 – Innovation Awards Sydney 11 th and 12 th Oct 2012. Short Term Multidisciplinary Rehabilitation Team (SMART) Presenter: Anna Butcher Rehabilitation Coordinator. Hospital Royal North Shore. KEY PROBLEM. Waiting for Rehab

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Hospital Royal North Shore

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  1. Innovation Poster Session HRT1215 – Innovation Awards Sydney 11th and 12th Oct 2012 Short Term Multidisciplinary Rehabilitation Team (SMART)Presenter: Anna Butcher Rehabilitation Coordinator Hospital Royal North Shore

  2. KEY PROBLEM Waiting for Rehab Rehabilitation not provided whilst patients are awaiting transfer to subacute rehabilitation facility Iatrogenic disability causes loss of function and need for prolonged rehabilitation. Deconditioning is the second most common reason for rehabilitation referrals.

  3. AIM OF THIS INNOVATION Implement In-reach to acute MoC- provide rehabilitation at earliest possible time Improve patient function Reutilization of subacute rehabilitation beds Reduced LOS in acute and waiting times for rehab type changed patients

  4. BASELINE DATA Ward review point prevalence study 12/5/11 (snapshot) 67of 345(19%) patients waiting for rehab 27 awaiting assessment 37 plan in place for rehab Nil had an acute hospital plan for rehab Rehab type change not associated with treatment Patient access Transport unit and PAS ALOS 2010/11 was 7.2 days Rehab Type (n=117) PATU 4.4 days in 2010/11)

  5. KEY CHANGES IMPLEMENTED SMART: OT, PT, Rehab Specialist, Coordinator, AH assistant, (awaiting SW) Early assessment by AHP 7 day intensive therapy program with aim to discharge home Daily therapy intervention including group and individual sessions 3 weekly case conferencing Rehabilitation and discharge planning

  6. OUTCOMES SO FAR 2011/12 SMART patients treated n= 174 134 d/c home, 3 deceased, 33 to rehab, 4 to ACF Reduced LOS :SMART = 6 days Others = 7.2 d satisfaction: “ made me more aware of what will be needed at home”, “The amount of exercise was strengthening. I now walk with greater confidence”, “I have had 3 ops on spine and this was the best stay” Functional improvement consistent with AROC data: FIM av. 14.6 TUG av.  8.4

  7. LESSONS LEARNT Cluster patients on single ward for efficiency Function will improve in Acute care if treated Probable multiplying/pull effect by freeing rehab beds Real patient improvements with very little staffing input. Executive needs more evidence- RCT commenced

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