Allied Health Led Rehabilitation Referrals on a Neurosurgical Ward

Nichola Foster1, Jimena Garcia-Vega1

1Sir Charles Gairdner Osborne Park Health Care Group – Physiotherapy Department, , Australia

A retrospective audit of 60 cases admitted between 2018 to 2020 to the neurosurgical ward at SCGH was conducted. The purpose of this QI  was to  facilitate a timely rehabilitation referral process with the aim of reducing the time from patient’s admission/surgery to the time to referral completion and the time to waitlisting for rehabilitation. Rehabilitation referrals were efficiently submitted by the AH team within 7 – 10 days from date of surgical intervention or date of admission in 50% of cases. The complexity of patients requiring multiple neurosurgical interventions was the main contributing factor in delays. Patients with a single surgical intervention (category 3) or managed conservatively (category 4) achieved this benchmark by 59% for patients in category 3, and 80% for patients in category 4. Rehabilitation medical staff reported that the quality of referrals was much improved and enhanced by the standardised AH referral form, compared to referrals previously made by junior doctors. This QI served to inform a current pilot joint model of care between the Geriatrics and Neurosurgery teams.

A ‘snap shot’ of data was collected during the COVID-19 peak period i.e March to May 2020. A total of 24 out of the 60 cases audited were captured during this period The cohort with the most cases (66.6%) was category 3 patients, which had most cases requiring the over 65 rehabilitation service (n=10), which in terms of patient flow had shorter times lines in time post-surgery to initial referral, and time from waitlisting to discharge to a rehabilitation facility.


Mena is the senior physiotherapist for the state wide Neurosurgical Service of Western Australia at SCGH. She has 17 years experience, her main areas of clinical interest involve the acute and subacute management of patients with stroke, brain tumours, cerebrovascular conditions, traumatic brain injury, atraumatic spinal pathology, and other neurodegenerative conditions. She has completed masters in neurological rehabilitation (2016), and most recently was the recipient of a Churchill Fellowship (2019) to investigate subacute rehabilitation in the neurosurgical population, specifically in the area of neuro-oncology. Currently she holds an Adjunct Lecturer position at ECU, collaborating with the Neurorehabilitation and Robotics laboratory.

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