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Title: Reducing the length of stay for acute hospital patients needing admission into inpatient rehabilitation: a multicentre study of process barriers.
Epworth Authors: New, Peter
Olver, John
Other Authors: Andrianopoulos, Nick
Cameron, Peter
Stoelwinder, Johannes
Keywords: Rehabilitation
Health service accessibility
Patient discharge
Delivery of health care
Outcome and process assessment (healthcare)
Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.
Patient flow
Inpatient rehabilitation
Patient journey
Issue Date: Sep-2013
Citation: Intern. Med. J. 2013 Sep;43(9):1005-11
Abstract: Background: Patient flow is a major problem in hospitals. Delays in accessing inpatient rehabilitation have not been well studied. Aims: Measure the time taken for key processes in the patient journey from acute hospital admission through to inpatient rehabilitation admission in order to identify opportunities for improvement. Methods: Retrospective open cohort study. All patients admitted over 8- and 10-month periods during 2008 into two inpatient rehabilitation units in Melbourne, Australia. Main outcome measures were the duration of the following key processes: acute hospital admission until referral for rehabilitation, referral until assessment by the rehabilitation service, assessment until deemed ready for transfer to rehabilitation, ready for transfer until rehabilitation admission. Results: Three hundred and sixty patients were in the study sample (females = 186; 51.7%); mean age = 58.4 (standard deviation = 15.0) years. There was a median of 7 (interquartile range [IQR] 4–13) days from acute hospital admission till referral for rehabilitation, a median of 1 (IQR 0–1) day from referral till assessment, a median of 0 (IQR 0–2) days from assessment till deemed ready for transfer and a median of 1 (IQR 0–3) day from ready till admission into rehabilitation. Overall, patients spent 12.0% (804/6682) of their acute hospital admission waiting for a rehabilitation bed. Conclusions: There are opportunities to improve the efficiency of key processes in the acute hospital journey for patients subsequently admitted to inpatient rehabilitation; in particular, reducing the time from acute hospital admission till referral for rehabilitation and from being deemed ready for transfer to rehabilitation till admission.
DOI: 10.1111/imj.12227
PubMed URL:
ISSN: 1445-5994
Journal Title: Internal Medicine Journal
Type: Journal Article
Affiliated Organisations: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Rehabilitation and Aged Services, Department of Medicine, Monash Health, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Multicentre Studies
Appears in Collections:Health Administration

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