Implementing an inpatient rehabilitation Saturday service is associated with improved patient outcomes and facilitates patient flow across the health care continuum

Abstract

Purpose: To evaluate the effectiveness of the introduction of a Saturday inpatient rehabilitation service in improving patient outcomes and facilitating hospital access and flow. Methods: 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). Results: 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. Conclusions: 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.

Implications for Rehabilitation

• 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.

• Allied health
• inpatient rehabilitation
• outcomes
• saturday service

Acknowledgements

The authors would like to acknowledge the support of Robyn Hayles, Executive Director of Community Health and Rehabilitation Services; and Barwon Health and Maria Tucker, McKellar Inpatient Rehabilitation Centre Manager for this study. We also thank the McKellar Inpatient Rehabilitation Centre clinicians, allied health, medical and nursing for their support of this study.

Declaration of interest

The authors report no declarations of interest.