New Allied Health model of care: Early and intensive therapy for acute hospital trauma patients

Dr Lara Kimmel1,2, Ms Melissa Webb1, Mr Doug McCaskie1, Assoc Prof Lisa  Somerville1,3

1Alfred Health, Melbourne, Australia, 2Monash University, Melbourne, Australia, 3Latrobe University , Melbourne, Australia

Introduction: Evidence suggests that early and intensive allied health (AH) therapy may allow for improved outcomes following hospitalisation.  Whether this is applicable for trauma patients is unknown.

Methods: In 2018, the Transport Accident Commission and Alfred Health partnered to establish a new 7-day model of AH care for acute hospital trauma patients.  The team consisted of physiotherapists, occupational therapists, orthotists, speech pathologists, dietitians, social workers, neuropsychologists, clinical psychologists and allied health assistants.  The team was led by a multi-professional Allied Health Team Leader.

Underpinning the model of care was a quality management system and improvement science methodology to integrate, embed and sustain this new workforce. Outcomes include discharge destination, length of stay (LOS), discharge day/time, Hospital Acquired Complications and readmission rates as compared to a similar patient cohort in 2019.

Results: The 12-month project commenced in January 2020, paused for 6 months due to COVID, recommencing in November 2020.  Reporting, education, governance structure and learnings from the establishment of the team will be described.  Six month outcomes showed a decrease in ward LOS of 0.25 days (Median 3.2 days) with no increase in hospital readmission rate (9%). The 2020 cohort were found to have a 52% increase in the odds of being discharged home rather than to another inpatient bed (acute or rehabilitation) and there was a decrease in ICU readmissions of 1.3%.

Conclusion: Providing early, intensive AH therapy with a team based approach to patient care can lead to improved patient and hospital outcomes, and reduce health service utilisation.


Biography:

Lara has been a physiotherapist at The Alfred in Melbourne for over 20 years and has a passion for research having completed a PhD at Monash University in 2016.  Her interests include targeting therapy in order to achieve improved hospital and patient outcomes.

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