Hakkennes Sharon, Lindner Christopher, Reid Jodie
Department of Physiotherapy and.
Disabil Rehabil. 2015;37(8):721-7. doi: 10.3109/09638288.2014.939772. Epub 2014 Jul 23.
To evaluate the effectiveness of the introduction of a Saturday inpatient rehabilitation service in improving patient outcomes and facilitating hospital access and flow.
A quasi-experimental study with a historical comparison group is presented. Data were evaluated for the 477 patients admitted and discharged in the 6 months following the implementation (October 2012-March 2013) of the service and 499 patients in the historical control group (April 2012-September 2012).
Prior to the introduction of the service median number of patients admitted on a Saturday was 0 (range 0-3), post-implementation the median number of patients admitted on a Saturday increased to 2 (range 0-5), this difference was statistically significant (Z = -3.61, p < 0.001). Median regression modelling demonstrated that, after adjusting for admission Functional Independence (FIM) score, gender, length of stay (LOS) and age, there was a small but significant increase in discharge FIM scores (median increase 2.28, p = 0.027) for those patients admitted in the post-implementation phase. There was no such effect of the service on LOS.
The implementation of the Saturday inpatient rehabilitation service was associated with improved patient outcomes and supported an increase in patient flow throughout the organization as evidenced by an increased number of Saturday patient admissions.
Inpatient rehabilitation services do not operate in isolation; they are a critical link in the healthcare continuum. There is a mounting body of evidence that the introduction of weekend rehabilitation services has a positive impact on patient outcomes. To maximize health outcomes, access to critical services and patient flow, organizations and staff need to move away from the long-standing 5-day/week inpatient rehabilitation model and start transitioning to a model that incorporates weekend therapy services.
评估引入周六住院康复服务在改善患者治疗效果、促进医院就诊机会和流程方面的有效性。
开展一项带有历史对照组的准实验研究。对该服务实施后6个月(2012年10月至2013年3月)收治并出院的477例患者以及历史对照组(2012年4月至2012年9月)的499例患者的数据进行评估。
在该服务引入之前,周六收治患者的中位数为0(范围0 - 3),实施后周六收治患者的中位数增加至2(范围0 - 5),这一差异具有统计学意义(Z = -3.61,p < 0.001)。中位数回归模型表明,在对入院时的功能独立性(FIM)评分、性别、住院时长(LOS)和年龄进行调整后,实施阶段后入院的患者出院时FIM评分有小幅但显著的增加(中位数增加2.28,p = 0.027)。该服务对住院时长没有此类影响。
周六住院康复服务的实施与改善患者治疗效果相关,并支持了整个机构患者流量的增加,周六患者入院数量的增加证明了这一点。
住院康复服务并非孤立运作;它们是医疗保健连续统一体中的关键环节。越来越多的证据表明,引入周末康复服务对患者治疗效果有积极影响。为了使健康结果、关键服务的可及性和患者流量最大化,机构和工作人员需要摒弃长期以来的每周5天住院康复模式,开始向纳入周末治疗服务的模式转变。