Quality Improvement Project: Reduce Waiting Time for Inpatient Spinal Cord Injury Rehabilitation Transfer from Orthopedic and Neurosurgery to Rehabilitation Unit

Abstract

<h3>Research Objectives</h3> Spinal cord injury (SCI) is a disabling condition for which early rehabilitation is important to improve patient's mobility and ability to perform daily activities. SCI patients who are accepted for inpatient rehabilitation would be transferred to a designated Rehabilitation unit as soon as possible so they can receive highly specialized SCI care provided by a designated Rehabilitation Team. However, the average waiting time for SCI patients is 8 days. Long waiting times result in delay of initiation of the rehabilitation program and risk of developing complications from prolonged hospital stay. As such, we conducted this Quality Improvement (QI) project to reduce the waiting time for inpatient rehabilitation transfer for SCI patients. We aim to reduce the waiting time for Spinal cord injury inpatient rehabilitation transfer. <h3>Design</h3> A QI team was formed to discuss the root causes which lead to long waiting times for inpatient rehabilitation transfer. Fishbone diagram was applied. Based on the root causes identified, weighted voting from the team members identified the main cause(s) to target. <h3>Setting</h3> Hospitalised care. <h3>Participants</h3> Patients with SCI and suitable to transfer to Rehabilitation Unit for inpatient rehabilitation. <h3>Interventions</h3> Pareto chart was applied to identify the main cause(s) to target. The main causes to target at PDSA cycle one were as follows: 1) Lack of knowledge of Rehab physicians; 2) No standard bed booking process. Based on the issues identified, Plan, Do, Study, Act (PDSA) cycle was carried out. The plan for PDSA cycle one was to form a designated SCI Inpatient Rehabilitation team to review SCI referrals and arrange transfer once a decision to take over is made. <h3>Main Outcome Measures</h3> The average waiting time for SCI patients to transfer to inpatient rehabilitation unit. <h3>Results</h3> A run chart was carried out and it showed the waiting time for transfer was reduced. <h3>Conclusions</h3> A designated SCI Inpatient Rehabilitation team to review SCI referrals and arrange transfer is an effective way to reduce waiting time for inpatient rehabilitation unit transfer for SCI patients. <h3>Author(s) Disclosures</h3> All authors listed on the abstract have no disclosures.