Local solutions improve rehabilitation outcomes after major trauma in New Zealand – A national rehabilitation collaborative
Kathryn Quick1, Jessica Lockett1
1Health Quality And Safety Commission, Wellington, Wellington, New Zealand
Abstract
Background
People with major trauma are defined as having a serious threat to life, and most will require extensive rehabilitation. Although trauma care has improved over the past 5-years, there remained key system issues that impact patient recovery, such as inequitable access to care, late diagnosis of complex conditions and fragmented follow-up.
Method
Between March 2021 and June 2022, nine teams undertook a national rehabilitation collaborative. The project aimed to:
•Optimise existing trauma rehabilitation provision, access and outcomes.
•Identify initiatives to remove barriers to achieving optimal outcomes.
•Increase clinician quality improvement (QI) skills and knowledge.
The project used the Institute for Healthcare Improvement’s breakthrough series collaborative model. Projects were co-designed with patients and utilised QI tools to identify problem areas, explore measurable change ideas and review existing inequities. Robust data collection plans were established using quantitative and qualitative methods.
Outcomes
Teams implemented lasting service improvements that resulted in improved outcomes for patients. These included: increased satisfaction by introducing a systematic process to allocate early case management, reduced waiting times into community services, greater access to inpatient rehabilitation and incorporation of Hauora Māori principles within rehabilitation.
Since completion of the collaborative two projects have been scaled across New Zealand.
Participants who completed the final evaluation displayed high levels of confidence in using QI methodology, and 90% felt that they had implemented meaningful rehabilitation service improvements.
Biography
Physiotherapist, Kat Quick is currently clinical lead for trauma rehabilitation at Te Tāhū Hauora Health Quality & Safety Commission. Kat has 19 years of experience in trauma and neurological rehabilitation in New Zealand and the UK, ranging across the patient pathway from acute to community settings. Kat is national chair of the projects’ expert advisory group and has been leading this work since 2020. After completion of her Greenbelt qualification in 2017, Kat has been passionately involved in quality improvement projects that support clinical service efficiencies and enhanced outcomes for patients and whānau.