133 A CO-ORDINATED EFFORT: THE ADDITION OF A REHABILITATION COORDINATOR TO GERIATRICIAN LED OLDER PERSONS REHABILITATION SERVICES

Abstract

Abstract Background It is well recognised that acute illness and hospitalisation can be associated with significant deterioration in mobility and function in older people. Flow to appropriate rehabilitation services has impacts not only on individual recovery but also in efficient utilisation of healthcare resources. This study describes the impact of a therapy trained Rehabilitation Coordinator (RC) on access to off-site inpatient and day hospital specialist rehabilitation services. Methods Over 6 months the rehabilitation coordinator collaborated with acute and community services to triage, assess and effectively utilise off-site specialist rehabilitation services with specific reference to role development, feasibility and safety. Key performance indicators measured included assessments completed, time from referral to assessment, time from accepted to transferred, number of admissions and length of stay. This data was compared against a 6-month control. Results The rehabilitation coordinator was involved in over 445 assessments (n=258 patients) in the 6 months of the study. Trusted assessment by the RC was assessed as equivalent to assessments completed by Consultant Geriatricians. COVID restrictions resulted in a reduction in available rehabilitation beds between the control and pilot periods. There was a 22% increase in rehabilitation admissions and a 63% reduction in mean length of stay during the pilot period. There was also a reduction in average time from referral to assessment (1.5 working days versus 5.6 workings days); and time to transfer to rehabilitation (2.1 days versus 6.7 days). New pathways of care developed included rapid access to day hospital care from acute inpatient care. Additional benefits were seen in RC-led education, quality improvement and research projects. Conclusion The addition of a rehabilitation coordinator enhanced patient access to and progress through inpatient and outpatient older person’s rehabilitation services. The RC provided both oversight and continuity of care throughout the patient journey between hospital and home.