Article

Prospective open cohort case series. OBJECTIVES: To identify
opportunities for improvement by recording duration of key processes from acute
hospital admission until spinal rehabilitation unit (SRU) admission. SETTING:
SRU, Victoria, Australia. METHODS: Consecutive referrals of patients with recent
spinal cord damage had prospective documentation of the key clinical and
demographic characteristics and duration (days) of the following sequential
discrete processes: acute hospital admission until referral to SRU, referral
until SRU assessment, SRU assessment until ready for transfer to SRU and ready
for transfer until SRU admission. RESULTS: A total of 347 patients were referred
with median age (interquartile range (IQR)) of 65 (52-76) years. Most patients
were male (n=203, 58.5%), had paraplegia (n=267, 77%) and an aetiology due to
spinal cord myelopathy (n=280, 80.7%). There was a median of 12 days (IQR 6-20)
from acute hospital admission until referral, a median of 1 day (IQR 0-2) from
referral till assessment, a median of 0 (IQR 0-3.5) days from assessment till
deemed ready and a median of 7 (IQR 2-20) days from deemed ready until transfer
to SRU. Overall, patients spent 34.2% (4951/14 478 days) of their acute hospital
length of stay waiting for a SRU bed. CONCLUSIONS: There are opportunities to
improve the efficiency of the acute hospital journey for patients referred to a
SRU. The biggest opportunities exist for reducing the time from acute hospital
admission till referral to SRU and the time from deemed ready for transfer to SRU
till admission.

Langue : ANGLAIS