The impact of staffing model in a 6‐day rehabilitation physiotherapy service

Caruana, Erin L.; Kuys, Suzanne; Clarke, Jane; Brauer, Sandra G.

doi:10.1002/pri.1701

Cited by 6 publications

(10 citation statements)

References 34 publications

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“…It is reasonable to suggest that discharge is likely determined by patient readiness, functional performance, and preparedness of the home environment [ 40 ]. Previous studies have reported similar discharge function from inpatient rehabilitation [ 11 , 41 ]. Interestingly differences in cognitive function were noted between the two groups at discharge.…”

Section: Discussionmentioning

confidence: 75%

“…One reason for the inconsistent effect on reduction in LOS maybe in the referral of a heterogeneous mix of patients for rehabilitation. Pragmatic implementation of a Saturday OT and PT rehabilitation service in an inpatient clinical setting would likely prioritise patients likely to benefit from [ 11 – 13 ] and be motivated to engage in additional rehabilitation [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Additional saturday occupational therapy for adults receiving inpatient physiotherapy rehabilitation: a prospective cohort study

Caruana

Rowell

Kuys

et al. 2022

BMC Health Serv Res

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Background The first aim of this study was to investigate the impact of providing an additional four hours of Saturday occupational therapy to patients receiving Saturday physiotherapy in an inpatient setting on length of stay, functional independence, gait and balance. The second aim was to conduct an economic evaluation to determine if the introduction of a Saturday occupational therapy service in addition to physiotherapy resulted in a net cost savings for the rehabilitation facility. Methods A prospective cohort study with a historical control was conducted in an Australian private mixed rehabilitation unit from 2015–2017. Clinical outcomes included the Functional Independence Measure (Motor, Cognitive, Total), gait speed (10 Meter Walk test) and five balance measures (Timed Up and Go test, Step test, Functional Reach, Feet Together Eyes Closed and the Balance Outcome Measure of Elder Rehabilitation). Economic outcomes were rehabilitation unit length of stay and additional treatment costs. Results A total of 366 patients were admitted to the rehabilitation unit over two 20-week periods. The prospective cohort (receiving Saturday occupational therapy and physiotherapy) had 192 participants and the historical control group (receiving Saturday physiotherapy only) had 174 participants. On admission, intervention group participants had higher cognitive (p < 0.01) and total (p < 0.01) Functional Independence Measure scores. Participation in weekend therapy by the intervention group was 11% higher, attending more sessions (p < 0.01) for a greater length of time (p < 0.01) compared to the historical control group. After controlling for differences in admission Functional Independence Measure scores, rehabilitation length of stay was estimated to be reduced by 1.39 (p = 0.08) days. The economic evaluation identified potential cost savings of AUD1,536 per patient. The largest potential savings were attributed to neurological patients AUD4,854. Traumatic and elective orthopaedic patients realised potential patient related cost savings per admission of AUD2,668 and AUD2,180, respectively. Conclusions Implementation of four hours of Saturday occupational therapy in addition to physiotherapy results in a more efficient service, enabling a greater amount of therapy to be provided on a Saturday over a shorter length of stay. Provision of multidisciplinary Saturday rehabilitation is potentially cost reducing for the treating hospital.

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Additional saturday occupational therapy for adults receiving inpatient physiotherapy rehabilitation: a prospective cohort study

Caruana

Rowell

Kuys

et al. 2022

BMC Health Serv Res

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“…38 Previous studies have reported similar discharge function from inpatient rehabilitation. 12,39 Interestingly differences in cognitive function were noted between the two groups at discharge. The intervention group had better cognitive function at discharge compared to the control group, though both groups scores would suggest discharge home would be likely.…”

Section: Discussionmentioning

confidence: 93%

“…11 One reason for the inconsistent effect on reduction in LOS maybe in the referral of a heterogeneous mix of patients for rehabilitation. Pragmatic implementation of a 6-day multidisciplinary rehabilitation service in an inpatient clinical setting would likely prioritise patients likely to benefit from [12][13][14] and motivated to engage in additional rehabilitation. 15,16 Providing weekend rehabilitation will likely incur additional costs for facilities.…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary versus physiotherapy-only weekend rehabilitation: A prospective cohort study

Caruana

Rowell

Kuys

et al. 2021

Preprint

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Background This study aims to investigate the impact of multidisciplinary Saturday rehabilitation (MSR) on length of stay, functional independence, gait and balance when compared to a 6-day physiotherapy-only service in a pragmatic setting. An economic evaluation of the intervention conducted from the perspective of the healthcare provider is included.Methods A prospective cohort study with a historical control was conducted in an Australian private mixed rehabilitation unit to compare a multidisciplinary and physiotherapy-only 6-day rehabilitation service. Clinical outcomes included the Functional Independence Measure (Motor, Cognitive, Total), gait speed (10 Meter Walk test) and five balance measures (Timed Up and Go test, Step test, Functional Reach, Feet Together Eyes Closed and the Balance Outcome Measure of Elder Rehabilitation). Economic outcomes were rehabilitation unit length of stay and additional treatment costs.Results A total of 366 patients were admitted to the rehabilitation unit over two 20-week periods. The prospective cohort (MSR) had 192 participants and the historical control group (physiotherapy Saturday rehabilitation) had 174 participants). Participants in the historical control group had lower total and cognitive Functional Independence Measure scores (p < 0.078), and generally performed at a lower level on admission gait and balance measures compared to the prospective cohort. More participants in the prospective cohort attended weekend therapy, attending more sessions and spending more time in therapy compared to those in the historical control group (p < 0.012). After controlling for differences in admission Functional Independence Measure scores, length of stay was reduced by 1.39 ± 0.77 days. The economic evaluation estimated cost savings of $1,536 per patient. The largest savings were attributed to neurological patients $4,854. Traumatic and elective orthopaedic patients realised cost savings per admission of $2,668 and $2,180, respectively.Conclusions Implementation of MSR results in a more efficient service, enabling a greater amount of therapy to be provided over a shorter length of stay. The provision of a multi-disciplinary Saturday rehabilitation is potentially cost reducing for the treating hospital.Trial registration not applicable.

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“…As approximately half of those units not currently providing a weekend service were considering providing a service in future, this may explain the dissatisfaction. More respondents from rehabilitation units providing a weekend service felt the provision of a weekend service reduced slip‐back in progress over the weekend, which may be reflective of the increased FIM scores and increased FIM efficiency scores seen elsewhere with six‐day service provision. Respondents were asked to indicate their level of agreement with all statements in the clinician perspectives questions as there was no option provided for ‘not applicable’.…”

Section: Discussionmentioning

confidence: 99%

Allied health weekend service provision in Australian rehabilitation units

2018

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The impact of staffing model in a 6‐day rehabilitation physiotherapy service

Abstract: Staffing a weekend rehabilitation service with physiotherapists currently working in rehabilitation influences functional independence. Different diagnostic groups appear to respond differently.

Cited by 6 publications

References 34 publications

Additional saturday occupational therapy for adults receiving inpatient physiotherapy rehabilitation: a prospective cohort study

Additional saturday occupational therapy for adults receiving inpatient physiotherapy rehabilitation: a prospective cohort study

Multidisciplinary versus physiotherapy-only weekend rehabilitation: A prospective cohort study

Allied health weekend service provision in Australian rehabilitation units

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