Abstract TP118: Development and Integration of a Dedicated Neurorehabilitation Space Within a Hospital-Based Stroke Unit

Abstract

Background: It is well documented that rehabilitation post-stroke is associated with better functional outcomes, however, in the United States access to post-acute care rehabilitation is becoming increasingly limited. The Office of the Inspector General recently reported that 13% of Medicare beneficiaries were denied access by some Medicare Advantage Organizations to medically necessary care, including admission to inpatient rehabilitation facilities (IRF). Further, the Centers for Medicare and Medicaid Services have initiated the Review Choice Demonstration (RCD) for IRF Services in several states which is anticipated to further reduce access to post-acute care rehabilitation. In response, when our institution began planning for a new neuroscience unit, the decision was made to build a dedicated neurorehabilitation space. The purpose of this project was to design a space that would increase patient access to high quality, intensive neurorehabilitation in the hospital setting. Methods: To maximize utilization and effectiveness of the space, the neurorehabilitation staff were involved in the design of the layout and the selection of appropriate equipment, and participated in several training sessions. One year after opening, the neurorehabilitation staff were surveyed about their access to necessary equipment, and their perception of the effects different features of the space had on the quality of their treatment sessions. Results: Of the 20 surveys completed, the percentage of staff who reported they had the necessary equipment increased from 35% to 100%, and 90% of the space’s features had a favorable effect on the quality of the treatment sessions. Additionally, 95% of staff reported that the overall time spent with each patient increased and overall job satisfaction improved from 60% to 85%. Conclusion: A dedicated rehabilitation space was developed to better meet the needs of the neurorehabilitation staff, and to improve patient access to neurorehabilitation in the hospital setting. Survey results suggested that job satisfaction and staff’s perception of therapy quality improved after opening the new space.