PMID- 33000174
OWN - NLM
STAT- MEDLINE
DCOM- 20201123
LR  - 20201123
IS  - 1651-2081 (Electronic)
IS  - 1650-1977 (Linking)
VI  - 52
IP  - 10
DP  - 2020 Oct 16
TI  - Benchmarking length of stay for inpatient stroke rehabilitation without adversely 
      affecting functional outcomes.
PG  - jrm00113
LID - 10.2340/16501977-2746 [doi]
AB  - OBJECTIVE: To evaluate the effects of introducing the practice of targeting a 
      discharge date for patients admitted to an inpatient stroke rehabilitation unit 
      on process and patient outcomes. DESIGN: Comparison of retrospective (control 
      group n = 69) and prospective (experimental group n = 60) patients. METHODS: 
      Rehabilitation professionals assessed both groups at admission and discharge 
      using a standard-ized assessment toolkit. Benchmarks for length of rehabilitation 
      stay (LoRS) were introduced based on median severity-specific LoRSs in the 
      control group. The multidisciplinary team documented facilitators and obstacles 
      affecting the prediction of patient benchmark attainment. Categorical variables 
      were compared using a chi2 test with exact probabilities. Ordinal and continuous 
      variables were analysed using rank-based non-parametric analysis of variance. 
      Effect sizes were estimated using a relative treatment effect statistic. RESULTS: 
      The mean combined length of stay in acute care and rehabilitation beds for the 
      experimental group (82 days) was shorter (p = 0.0084) than that of the control 
      group (103 days). This 21-day reduction in combined length of stay included a 
      10-day reduction in the mean time between stroke onset and admission to the 
      stroke rehabilitation unit (p = 0.000014). Improvements in 6 func-tional and 
      sensorimotor outcomes with rehabilitation were of similar magnitude in both 
      groups, while Functional Independence Measure (FIMTM) efficiency improved 
      (p = 0.022). The team was 87% successful in predicting which patients were 
      discharged on the LoRS benchmark. CONCLUSION: Benchmarking the length of stay in 
      rehabilitation resulted in reduced bed occupation and system costs without 
      adversely affecting functional and sensorimotor patient outcomes.
FAU - Durand, Anne
AU  - Durand A
AD  - Centre integre universitaire de sante et de services sociaux (CIUSSS) de la 
      Capitale-Nationale (Institut de readaptation en deficience physique de Quebec), 
      G1M 2S8 Quebec City, Canada.
FAU - D'Amours, Line
AU  - D'Amours L
FAU - Giroux, Annie
AU  - Giroux A
FAU - Pelletier, Maryse
AU  - Pelletier M
FAU - Leblond, Jean
AU  - Leblond J
FAU - Richards, Carol L
AU  - Richards CL
LA  - eng
PT  - Journal Article
DEP - 20201016
PL  - Sweden
TA  - J Rehabil Med
JT  - Journal of rehabilitation medicine
JID - 101088169
SB  - IM
MH  - Benchmarking/*methods
MH  - Female
MH  - Humans
MH  - Inpatients
MH  - Length of Stay/*statistics & numerical data
MH  - Male
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Stroke Rehabilitation/*methods
OTO - NOTNLM
OT  - benchmarking
OT  - inpatient rehabilitation
OT  - length of stay
OT  - quality improvement
OT  - stroke
EDAT- 2020/10/02 06:00
MHDA- 2020/11/24 06:00
CRDT- 2020/10/01 05:39
PHST- 2020/10/02 06:00 [pubmed]
PHST- 2020/11/24 06:00 [medline]
PHST- 2020/10/01 05:39 [entrez]
AID - 10.2340/16501977-2746 [doi]
PST - epublish
SO  - J Rehabil Med. 2020 Oct 16;52(10):jrm00113. doi: 10.2340/16501977-2746.