206 Changing needs in a rehabilitation setting—fact or fiction?

Abstract

Abstract Background Various pathways have been developed for older persons in our region, e.g. Reablement and the Integrated Care Team for Older Persons. Do these developments impact on referrals to our rehabilitation unit? The perception is that our client base is becoming more complex. A service evaluation was completed to examine this. This has implications for the planning of resources for us and the region in line with the National Standards for Safer Better Healthcare (2012). Methods A retrospective chart audit was performed on all discharged physiotherapy charts for 2019, 2021 and 2022. Categories were themed for: reason for admission to acute services, transfer ability (bed to chair) preadmission, on admission to the rehabilitation unit and on discharge. Levels of assistance needed were itemised as: independent, assistance of one, assistance of two, use of a Sara Steady and use of a hoist. Discharge destination was reviewed. Results A total of 339 charts were reviewed. Reason for admission to acute services was consistent: acute medical reasons, stroke, hip fracture and ‘falls’. The majority of clients were independent in transfers before admission: 93% in 2019 which dropped to 81.5% in 2022. On admission to the rehabilitation ward those needing assistance of two people rose from 16.8% (2019) to 21.8% (2022). The use of a hoist rose by 6%. On discharge, those assessed as being independent dropped from 63% (2019) to 44.6% (2022). Those needing assistance of 1 increased from 21.8% (2019) to 41.1% (2022). Those requiring a hoist rose; 2% (2019) to 7.2% (2022). The majority of clients were discharged home; 75% (2019) which fell to 65% in 2022. Conclusion The review highlights that there is a trend towards increased levels of assistance needed for clients admitted onto, and being discharged from, the rehabilitation unit. This has workforce and environmental implications for our unit in terms of planning of resources. Further evaluation is warranted to examine ongoing trends.