Mr Matt Vickers1, Stephanie Gleeson1, Cath Butler1, Jemma Sanders1, Steph Dempsey1, Mr Peter Hough1
1Peninsula Health, Mornington, Australia
Background: In 2017, a new funding model for subacute inpatient services in Victoria identified length of stay performance at Peninsula Health longer than the state average. To address this, a new model of care delivery was created through an Allied Health rapid discharge team at The Mornington Centre. This team identified a range of change opportunities including extended roles for a grade 3 Allied Health Assistant. Up until that time the therapist/Allied Health Assistant relationship involved the AHA working within clear but constrained guidelines in the provision of patient care.
Method: A dedicated team called SPeED (Supporting Patient Centred Early Discharge), was made up of five Allied Health clinicians including a new role created for a Grade 3 Allied Health Assistant (AHA). This position established strategies to challenge former barriers to rapid discharge. These included incomplete and delayed patient screening/goal setting on admission, suboptimal interdisciplinary team communication, passive in-patient behaviours, fragmented therapeutic practise, delays with equipment provision and restrictive frameworks for the AHA to progress patient mobility. The AHA contributed strongly to a patient centred team focus commencing with early patient goal setting and establishment of a procedural KPI suite. Team member perceptions of this changed role were captured as a thematic review from a staff survey. Positive patient outcomes had been captured in an earlier comparison with a matched historical sample.
Results: Feedback from staff about the role of the AHA in the team delivery of patient care was universally positive. Survey responses identified this as a critical component in patient outcomes.
Discussion: Safe and effective early patient discharges meeting patient own discharge goals have been demonstrated with the introduction of a dedicated Allied Health team (SPeED). This study identified the importance of the role of the grade 3 AHA in turning potential early discharge barriers into achievable hurdles.
Peter is senior physiotherapist and co-leader in the design and implementation of the Supported Patient centred Early Discharge (SPeED) programme at Peninsula Health. He has worked in senior physiotherapy management for over 30 years with a passion for subacute Rehabilitation and Geriatric Evaluation and Management.