Geriatric, adult rehabilitation and stroke service (GARSS) day therapy model of care

Dr Nisal Gange1, Samantha Gollan2, Frances Mattocks3

1Geriatric, Adult Rehabilitation and Stroke Service, Toowoomba Hospital, PMB2, Toowoomba, 4350, nisal.gange@health.qld.gov.au
2Geriatric, Adult Rehabilitation and Stroke Service, Toowoomba Hospital, PMB2, Toowoomba, 4350, sam.gollan@health.qld.gov.au
3Geriatric, Adult Rehabilitation and Stroke Service Toowoomba Hospital, PMB2, Toowoomba, 4350, frances.mattocks@health.qld.gov.au

Background

Day therapy (DT) services have been shown to improve patients’ ability to undertake activities of daily living and reduce risk of deterioration post discharge from hospital. The Toowoomba Hospital DT team recently underwent extensive service reform with a number of new initiatives implemented. The goals of the reform were:

  • To ensure holistic multi-disciplinary patient-centred care
  • To maximise efficiency to cater for increasing demand and patient complexity and acuity;
  • To improve patient flow.

The purpose of this project was to evaluate whether these goals were achieved.

Method

A retrospective cross-sectional study was conducted. Effectiveness of service parameters were evaluated and compared for a 3 month period pre (2012) and post (2014) implementation of changes.

Results

A 31% increase in referral numbers post implementation of changes was observed. The proportion of clients who had a multi-disciplinary needs assessment increased 2.5 times. Average waiting times were also reduced with Multi-disciplinary needs assessment completed in 4 days compared to 22, and median waiting time from referral to the first appointment reduced from 40 to 22 days.  Whilst patients required a similar number of admissions to hospital in the 6 months following DT service, the median acute length of stay was reduced from 8 to 3 days and the sub-acute length of stay reduced from 13 to 0. This equates to an approximate cost saving of $173,304 in a 3 month period.

Discussion

The introduction of an advanced Trans-disciplinary role, early multidisciplinary screening and streamlining of processes and procedures have resulted in improvements in the efficiency and effectiveness of the DT service. This has allowed for a streamlined respond to the increasing service demand, improved patient-centred practice and timely access to clinically appropriate multidisciplinary care.

Biography

Fran Mattocks is an Occupational Therapist with 13 years experience working in rural health. Currently employed as the Advanced Allied Health Practitioner within the Geriatric Adult Rehabilitation and Stroke Service (GARSS) at Toowoomba Hospital, with a clinical focus on sub acute care.