Specific timely appointments for triage in a regional neurological community based setting.

Abstract

Background/aim: The National Stroke Foundation Guidelines outline the need for timely access to goal directed and context specific, patient centred care. Patients attending Grampians Health for neurological rehabilitation in the Community Rehabilitation Centre (CRC) often experience delayed treatment due to extensive wait lists, resulting in poorer outcomes and extended episodes of care. In 2019, the wait list to access Occupational Therapy (OT) specific intervention reached greater than 80 patients. The Specific Timely Appointments for Triage (STAT) model is an evidence based approach to facilitate early assessment, education and intervention for patients. This occurs through creation of protected appointment slots and clinician-led combined triaging and assessment to facilitate immediate commencement of treatment. The aim of this project was to measure the outcomes of the STAT model in a neurological population in a regional CRC. Population/setting: Patients who have experienced a neurological event or condition and attended the Grampians Health CRC. Methods: A single-site retrospective audit was conducted. STAT was implemented by the senior allied health clinicians and included ten hours of dedicated phone and face to face triage and assessment. Descriptive statistics were utilised for analysis. Results: Over a 5 month period, 37 patients were triaged using STAT and a total of 16 interventions were offered. 15 (40%) participants required only one appointment, access to treatment ranged from 1 day to 12 weeks and the OT waiting list reduced by 57%. Ten patients were surveyed regarding satisfaction, with 100% of patients feeling that the initial appointment was worthwhile, needs were appropriately identified and the interventions were beneficial. Conclusion: The STAT model has been successful in improving patient access to neurological rehabilitation in a regional CRC. STAT allows for a wide scope of therapeutic interventions and is well received by patients. Translational impact/implications for future practice: STAT allows more equitable access to services through managing variability in waiting times, optimising functional outcomes and reducing deterioration. Combined triaging and assessment during protected clinical time allows for efficiency in care provision and caseload management. STAT has been proposed to maintain reduced waiting lists beyond one year. Ongoing data collection will allow evaluation of the long term maintenance of the STAT model.