A pragmatic implementation of a 6-day physiotherapy service in a mixed inpatient rehabilitation unit

Abstract

Purpose: This study determined the impact of a pragmatic 6-day physiotherapy service on length of stay, functional independence, gait and balance in people undergoing inpatient rehabilitation, compared to a 5-day service.

Method: A prospective cohort study with historical comparison was undertaken in a mixed inpatient rehabilitation unit. Intervention period participants (2011) meeting inclusion criteria were eligible for a 6-day physiotherapy service. All other participants, including the historical cohort (2010) received usual care (5-day physiotherapy). Length of stay, functional independence, gait and balance performance were measured.

Results: A total of 536 individuals participated in this study; 270 in 2011 (60% received 6-day physiotherapy) and 266 in 2010. Participants in 2011 showed a trend for reduced length of stay (1.7 days, 95%CI −0.53 to 3.92) compared to 2010. Other measures showed no significant differences between cohorts. In 2011, those receiving 6-day physiotherapy were more dependent, but showed significantly improved functional independence and balance compared to those receiving 5-day physiotherapy (p < 0.040) without impacting length of stay.

Conclusion: Implementing a 6-day physiotherapy service in a “real-world” rehabilitation setting demonstrated a trend towards reduced length of stay, and improved functional gains. This service could lead to cost-savings for hospitals and improved patient flow.

Implications for Rehabilitation

• “Real-world” implementation of a 6-day physiotherapy service in rehabilitation shows a trend for reducing length of stay.

• This reduction in length of stay may lead to cost-savings for the hospital system, and improve patient flow into rehabilitation.

• Patients receiving 6-day physiotherapy made significant gains in balance and functional independence compared to patients receiving 5-day physiotherapy services in the rehabilitation setting.

Keywords:

• Physiotherapy
• rehabilitation
• saturday service
• 6-day service
• length of stay
• outcomes

Acknowledgements

The authors wish to acknowledge the Queensland Rehabilitation Physiotherapy Network for awarding this study a small clinician research grant. We would also like to acknowledge the Physiotherapy and Rehabilitation Departments at St Andrew’s War Memorial Hospital for their support and hard work in the implementation of this service.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Funding

Erin Caruana was awarded a Queensland Rehabilitation Physiotherapy Network research award grant in 2011 to complete this study.