Mrs Fiona Darnell1, Mrs Kirby McAdam1
1Peninsula Health, Frankston, Australia
Biography:
Kirby is the Senior Physiotherapist in the Peninsula Health At Home Program, funded under the Victorian Better at Home initiative. The program covers >100 beds, including ‘admitted’ bed substitution beds and community funded beds. Kirby has worked in community physio for >15 years, including implementing an early supported discharge program in the UK and completing further study in Innovation and Implementation sciences.
Abstract:
Post elective arthroplasty care is variable in public health. Peninsula Health implemented a new model of care, whereby patients were streamed to a single rehabilitation pathway through the At Home Sub-acute (AHS) program. This consisted of initial individual physiotherapy and nursing visits, with further physiotherapy care predominantly delivered in a group setting. The expected length of stay (LOS) initially was 2-4 weeks. The aim was to review outcomes of the first 3 months of the pathway.
Data was obtained retrospectively from a file review of AHS physiotherapy between April-June 2024. Data extracted included: time between AHS admission and initial contact; referral pathways; patient’s 10m walk times; number of physiotherapy contacts; days from AHS admission to discharge.
In total, 117 post-arthroplasty patients were treated through the AHS program. 93% were seen by physiotherapy within 3 days of admission. For THR’s, 19% went on to require individual community rehabilitation program (CRP) physiotherapy input beyond their AHS 4 week LOS, 50% required group only therapy, and 21% required no referral after 4 weeks. For the TKR’s, 12% required individual physiotherapy input post 4 weeks AHS, 60% group only CRP input, and 23% no referral beyond 4 weeks. The average change in walking speed for THR’s was 0.44 metres per second (m/s) and 0.43m/s for TKR. The average time from admission to AHS to discharge from CRP ‘group only’ was 6.3 weeks for THR’s, and 7.1 weeks for TKR’s.
Group based therapy and shorter LOS is a feasible option for post arthroplasty patients.