Stroke Network Updates
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1 Stroke Network Updates SLP Network Deborah Willems March 21,
2 SWOSN Staffing Lyndsey Butler Regional Educator Paula Gilmore Regional Director Margo Collver Regional Community & LTC Coordinator
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5 Auditor General s Report on Rehab Lack of Coordinated Hospital Rehab System Highlights: Wide variation in supply of inpatient beds Lack of info on outcomes of long-term rehab (CCC) and outpatient rehab 25% of ALC waiting for rehab or CCC Few best practices (with the exception of stroke); as a result, practices varied across hospitals
6 Auditor General s Report on Rehab Recommendations: Province-wide referral system Public information available regarding access and eligibility criteria for rehabilitation programs Track therapy time Track reasons for denial to inpatient rehab Use one system for workload measurement Implement available best practices Provide outpatient services on evenings and weekends Track data for outpatients
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8 MOH Health System Funding Reform Hospitals, Community Care Access Centres and Long Term Care are the first sectors incorporated into the funding strategy Health System Funding Reform Patient-Based Funding is based on clinical clusters that reflect an individual s disease, diagnosis, treatment and acuity Patient-Based Funding (70%) Global (30%) Patient-Based Funding will include HBAM and Quality- Based Procedures Health Based Allocation Model (40%) Quality-Based Procedures (30%) (N.B. 40% and 30% noted is hospital specific; will be different for other sectors) HBAM is a made in Ontario funding model that distributes allocations to organizations in accordance with population needs and their ability to provide cost-effective care. Quality Based Procedures (QBPs) are clusters of patients with clinically related diagnoses or treatments that have been identified by an evidence-based framework as providing opportunity for process improvements, clinical redesign, improved patient outcomes, enhanced patient experience and potential cost savings
9 QBP: Quality Based Procedures Clinical Handbook for Stroke Phase 1 Acute Care Inpatient Rehabilitation Based on Best Practices
10 Recommended Stroke Performance Indicators Proposed Indicator Hours of rehab therapy provided in IP rehab % of inpatient rehabilitation patients achieving target RPG LOS Target Performance 3hrs/day RPG days RPG RPG RPG RPG RPG RPG
11 Decision Tree for Stroke Rehabilitation Patient Group RPG 1160 Stroke >50 Cognitive <30 Motor Motor Motor Age Cognitive 5-25 >= <=
12 Recommended Stroke Performance Indicators Proposed Indicator Hours of rehab therapy provided in IP rehab % of inpatient rehabilitation patients achieving target RPG LOS Target Performance 3hrs/day RPG days RPG RPG RPG RPG RPG RPG Based on patients receiving 3 hours/day inpatient therapy, availability of intensive therapy in the community and all patients discharged home upon reaching FIM score of 100.
13 QBP: Quality Based Procedures QBP funding for acute care and inpatient rehab not yet implemented Awaiting recommendations and implementation of Phase 2; Community. SWO representatives on Phase 2 Expert Panel include: Paula Gilmore, Matthew Meyer, David Ure, Karen Sutherland, Chris O Callaghan
14 Webcast You can also access the webcast: Taking Stroke Best Practices to the Next Level: An Introduction to Quality-Based Procedures and Health Quality Ontario s Stroke Clinical Handbook. Available on the OTN website. -Go to click on, Learning & Meetings, Webcasting, Webcasting Centre, click on Public Archived Events, and in the search window plug in the Event #:
15 AlphaFIM Project 740 Completion of the AlphaFIM is recommended in the Quality Based Procedures: Clinical Handbook for Stroke to inform discharge decision-making and align services to patient needs. Canadian Institute for Health Information working to make collection of the AlphaFIM mandatory in the DAD (acute care database) for all stroke admissions.
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