Objective:
Develop a Dynamic Process Model for Rehabilitation Medicine in an acute teaching hospital.
Method:
There were three steps in developing and implementing the rehab service model:
Firstly, engagement of multidisciplinary members of the department of Rehabilitation medicine to process map the referral, consultation and discharge transfer activities. Then, transfer this map to a dynamic interactive computer model. Finally,the introduction of new rehabilitation services using the model to inform best practice.
Results:
Referral Activity Data collected in financial year 2010/11 demonstrated a total number of n=1451 patients referred for inpatient rehabilitation. The following year 2011/12 indicated a reduction of 5% to n=1381. More importantly there was a reduction mean waiting time of transfer to rehabilitation from 4.7 days to 4.1 days. The overall saving associated with this intervention was 1262 beddays.

Implications/Impact on Rehabilitation:
The service changes that the model influenced were associated with considerable savings in beddays. The assessment process has been modified from single discipline (medical) to allied and multi-disciplinary team assessment. The treatment in acute care has been enhanced through the introduction of an acute in-reach rehabilitation service for general and renal patient groups. The discharge transfer activites have been streamlined to using existing services for improved home-based and ambulatory options for rehabiltiation post discharge. The reduction of length of stay can be attributed to a greater availability of rehabilitation subacute beds.