Reducing process barriers in acute hospital for spinal cord damage patients needing spinal rehabilitation unit admission.
METHODS
Prospective open cohort case series.


OBJECTIVE
To identify opportunities for improvement by recording duration of key processes from acute hospital admission until spinal rehabilitation unit (SRU) admission.


METHODS
SRU, Victoria, Australia.


METHODS
Consecutive referrals of patients with recent spinal cord damage had prospective documentation of the key clinical and demographic characteristics and duration (days) of the following sequential discrete processes: acute hospital admission until referral to SRU, referral until SRU assessment, SRU assessment until ready for transfer to SRU and ready for transfer until SRU admission.


RESULTS
A total of 347 patients were referred with median age (interquartile range (IQR)) of 65 (52-76) years. Most patients were male (n=203, 58.5%), had paraplegia (n=267, 77%) and an aetiology due to spinal cord myelopathy (n=280, 80.7%). There was a median of 12 days (IQR 6-20) from acute hospital admission until referral, a median of 1 day (IQR 0-2) from referral till assessment, a median of 0 (IQR 0-3.5) days from assessment till deemed ready and a median of 7 (IQR 2-20) days from deemed ready until transfer to SRU. Overall, patients spent 34.2% (4951/14 478 days) of their acute hospital length of stay waiting for a SRU bed.


CONCLUSIONS
There are opportunities to improve the efficiency of the acute hospital journey for patients referred to a SRU. The biggest opportunities exist for reducing the time from acute hospital admission till referral to SRU and the time from deemed ready for transfer to SRU till admission.
1] Spinal Rehabilitation Unit, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia [2] Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.
P W
0000000256693286
PW
New
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010360:Patient Transfer; D011446:Prospective Studies; D012044:Regression Analysis; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013997:Time Factors; D055815:Young Adult