As a result of the proposed roll-out of IeMR, it was required that we create additional bed space for the decanting of acute areas of Toowoomba Hospital. A decision was made to relocate a clinical ward offsite. The logical answer was to relocate our sub-acute Rehabilitation unit. This was the only patient type that could safely be separated from the acute hospital. Preparations for this relocation began in September 2018.
Relocating the existing Rehabilitation Unit to cater for patients' needs
Initiative Type
Service Improvement
Status
Close
Added
05 February 2020
Last updated
09 June 2020
Summary
Key dates
Sep 2018
Feb 2020
Implementation sites
Toowoomba Hospital
Partnerships
Multi-disciplinary team
Aim
- To free up additional space within the hospital for the implantation of IeMR. IeMR did not proceed but we decided to continue to move Rehabilitation as we believed this service would benefit by being a standalone service located off site.
- To enable the development of an improved rehabilitation program for patients that specifically catered to their needs.
- Achieve better patient outcomes for sub-acute patients requiring Rehabilitation or Geriatric Evaluation Management (GEMs) Programs.
Benefits
The model of care has changed to a true sub-acute model. The environment is conducive to better patient outcomes - There is a communal dining room and lounge room where all patients eat meals and do activities. There is a beautiful rural outlook and garden that patients can enjoy. We commenced a volunteer companionship program where patients get to enjoy doing arts, crafts, music, gardening etc. This has proved very beneficial to patient's wellbeing and improved health outcomes.
- Decrease in nurse sensitive indicators by 41% eg. falls, medication errors
- Favourable response in culture survey for nurses compared to previous year- increased staff satisfaction
- More dedicated time to meet the Rehab/GEMs program requirements leading to better patient outcomes
- Increased patient/ significant others satisfaction
- Cost effectiveness - due to subacute unit in standalone environment
- Decreased staffing costs: drop in HPPD and skill mix requirements
- Decreased costs in pathology, pharmacy, clinical supplies
- Decreased incidents = fiscal improvements as well as better patient outcomes
- Significant reduction in 1:1 nursing requirement = significant cost savings
- Very little agency use as staff base very stable
- Improved FIM scores
- Environment improvements - more bathrooms, two bed and single rooms
- Enriched environment - social, space, garden, outdoor areas, music, diversional activities, dining area, windows, views, natural light, animal visits
- Increase in length of stay but better patient outcomes- but noting a different patient cohort as no acute patients
- Central gym and therapy areas no competition for other services using this space- dedicated rehab Gym space
- Patients forming friendships and supporting each other
- Patients spending more time away from bedside e.g. meals, socialising, watching TV
- More opportunity for mobilising to dining room/lounge
- Increased program numbers 16 Rehab and 10 GEMS and beds.
- Increase in Allied Health and solely based in rehab for targeted program care
- Dedicated and ward kitchen on site is more personalised, patients don't have to fill out menu forms
- Audit results are showing marked improvements (i.e. SAFE and Quality Improvement)
- Decreased number of complaints/negative feedback
- Increased number of compliments
- Greater control over Rehabilitation resources
- Implementation of companionship program tailored to making a difference in these patients lives
- Arts and crafts
- Music therapy
- Dancing
- Men's activities, woodwork, gardening
- Visits from animals
Background
Additional hospital space was created fir the implementation of IeMR.
