Mrs Jessica Reinbott1, Doug Murtagh1
1Queensland Health, Toowoomba, Australia
A weekend transdisciplinary model of care was introduced to the Acute Stroke Unit (ASU) in 2015, resulting in increased adherence to National Stroke Guidelines. In 2018, the “Weekday Transdisciplinary Stroke Service” has been implemented based on current research that indicates a disparity between the physical and cognitive presentations of mild stroke patients particularly once they have been discharged home. This service has identified, assessed and provided inpatient and home-based interventions with a transdisciplinary allied health approach.
An observational pre-post study using quantitative methods was used to compare effectiveness and efficiencies between standard care and transdisciplinary acute stroke approach (pre-post implementation). Focus areas included comparison of input hours of care and number of allied health involved, quality and duplication of assessment, length of stay, patient journey and community follow up/referrals.
When compared, the transdisciplinary model of care demonstrated an average reduction in length of stay of 33.9 hours (a 31.8% reduction in mean length of stay). There was a reduction in both inpatient allied health occasions of service and time spent as well as duplication of assessments. Use of standardised outcome measures increased by 50%. There was an increase in outpatient service hours and referrals to community rehabilitation. Follow up home visits were completed in 6 days verse standard care being 43.5 days.
The transdisciplinary approach has increased the effectiveness of allied health inpatient input with an increased breadth of targeted assessment along the continuum of care and increased use of standardised outcome measures, whilst reducing length of stay, allied health input time and occasions of service. It can also be argued that supported discharges have led to more timely referrals for ongoing community rehabilitation. This approach has reduced the duplication of assessment and number of clinicians involved in patient care which has streamlined the patient journey.
In his current roles Doug provides trans-disciplinary Allied Health assessment and intervention, typically for older clients with sub-acute health care needs. He is involved in the care of patients presenting in the acute hospital setting, as well as those living at-risk in the community. He has a clinical background in neurological and vestibular rehabilitation, aged care and falls prevention.