Is the In-reach Rehabilitation Model of Care Effective and Efficient?
Sarah Parker1, Caitlin Mackenzie, Tina Yiu1 1Royal North Shore Hospital, St Leonards, NSW, Australia
Abstract
Background: The In-Reach Rehabilitation Model of care is designed to provide a multidisciplinary rehabilitation service to patients admitted to an acute hospital. The Functional Independence Measure (FIM) is a uniform system of measurement used in all Australian and New Zealand Rehabilitation Centres that measures level of disability. Admission and discharge FIM data are collected for all In-Reach patients admitted at Royal North Shore Hospital (RNSH). The In-Reach service has two streams; a stroke and a general rehabilitation service.
Method: The AN-SNAP calculator developed by the Australasian Outcome Rehabilitation Centre (AROC) was utilised to benchmark the In-Reach service against national averages of rehabilitation admissions. FIM efficiency was calculated for each stream. A FIM efficiency of >0.66/day is clinically significant. FIM efficiencies for all In-Reach patients were calculated over a 5 month period.
Results: The In-Reach service has a mean FIM efficiency of 1.42. Specifically, the FIM efficiency for the stroke service was 1.3 and general rehabilitation service was 1.5. For the patients being directly discharged home, FIM efficiencies were 2.3 and 1.4 for the stroke and general rehabilitation service respectively. For the group of patients transferred to inpatient rehabilitation facilities, the FIM efficiencies were 1.0 and 1.1 for the stroke and general rehabilitation service respectively. This demonstrates that the In-Reach program had clinically significant changes across all streams.
Conclusion: The In-Reach model of care at RNSH provides an effective and efficient rehabilitation service that improves patient outcomes and flow.
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