Background: The National Acute Stroke Service Framework provides evidenced based recommendations for service delivery of acute stroke patients to ensure equitable access to best practice stroke care across Australia. Primary Stroke centres, such as Bendigo Health, should provide an acute stroke unit with a dedicated stroke team who complete standardised assessment to determine individual rehabilitation needs and goals. Delivering optimal stroke services in regional Victoria remains a challenge and these criteria are yet to be met. Alternative solutions to such short-comings with the aim of improving patient outcomes should be explored.
Aims: We aim to increase the intensity of physiotherapy input for patient’s waiting inpatient rehabilitation.
Methods:
- Collect pre and post data on the physiotherapy intensity provided to patients on acute wards waiting for inpatient neurological rehabilitation.
- An in-reach physiotherapy service; consisting of three inpatient neurological rehabilitation physiotherapists taking over the physiotherapy care for patients on the acute wards once they have been identified as requiring inpatient rehabilitation.
Results:
- Baseline data was collected (n = 26) which demonstrated patients referred to in-patient rehabilitation received on average 3.4 sessions of physiotherapy for an average of 9.1 acute days waiting for a rehabilitation bed.
- An interventional study was conducted from March – May 2023. Based on current data (as of end of April 2023) we had 28 patients waiting an average of 10 days for an inpatient rehabilitation bed and receiving 6 physio sessions. 4 patients have been able to discharge from acute wards.
Conclusion:
- Little has been published regarding nuanced ways of improving patient outcomes in regional and rural health services.
- There was an increase in intensity provided to patients waiting for inpatient rehabilitation.
- Based on average length of stay this has saved 160 bed days.