Mrs Ruth Warr1, Mr Kien Chan3, Ms Karen Gifford2
1WA Country Health Service – Innovation & Development, Geraldton, Australia, 2WA Country Health Service – Innovation & Development, Perth, Australia, 3North Metropolitan Health Service – Osborne Park Hosptial, Osborne Park, Australia
Western Australian (WA) Midwest residents historically travel over 1000km to Perth stroke units to receive specialist inpatient rehabilitation in line with national Stroke Foundation recommendations.
The TeleStroke-Rehabilitation Project (“Project”) aims to provide timely and equitable access to high quality admitted stroke rehabilitation closer to home, provided by a skilled rural workforce, through dedicated links with a metro-based specialist stroke unit facilitated by telehealth.
The Project runs from April 2018 to June 2019, and supports the delivery of admitted stroke rehabilitation in Geraldton Hospital (GH) through linking with the Stroke Unit at Osborne Park Hospital (OPH) for specialist clinical advice and education. This is facilitated through telehealth-enabling (1) multidisciplinary clinical team meetings; (2) allied health clinical intervention sessions; (3) workforce education; and (4) clinical handovers between sites.
Compared to the 12 month period pre-trial, the Project is achieving: (1) increased rural self-sufficiency in providing stroke rehabilitation (87% of patients remaining in GH for their rehabilitation vs 69% pre-trial); (2) reduced average length of stay in metropolitan stroke rehabilitation units (22 to 14 days); (3) reduced average length of stay in GH (33 to 21 days); and (4) improved quality of stroke rehabilitation provided within GH indicated by improved adherence to stroke rehabilitation clinical performance indicators. High patient satisfaction with provision of care closer to home and improved rural workforce confidence in providing stroke rehabilitation has been recorded since commencement of telerehabilitation services.
Telehealth technology and dedicated links with metropolitan stroke units can be used to support rural allied health staff in providing high quality admitted stroke rehabilitation in a rural hospital, closer to home for country patients. Further system development is required to ensure public health funding models support provision of metro specialist services to rural therapists caring for stroke patients admitted in WA Country Health facilities.
biographies to come