Rehabilitation Intensity

Quality-Based Procedures (QBP) for stroke state that “stroke patients should receive, via an individualized treatment plan, at least 3 hours of direct task-specific therapy per day by the interprofessional stroke team for at least 6 days per week” ( Health Quality Ontario & Ministry of Health Long-Term Care, 2016 and p. 75)

In the Fall of 2014, a provincial integrated working group was formed to support rehabilitation programs and integrated stroke units across Ontario with the provision of greater rehab intensity and a standardized approach to collecting rehab intensity data.

Work plan

Final Report

Deliverables

1. Resource guide to support the measurement of rehabilitation intensity in in-patient stroke rehab (February 2015)

2. Stroke Rehab Intensity FAQ (Revised November 2017)

3. Presentation: Every Minute Counts- Stroke Rehab Intensity (February 2015)

4. Provincial slide deck to support rehabilitation intensity data collection by front line staff (February 2015)

5. Development of an OSN rehabilitation intensity communique (2015)

6. Development and implementation of 3 OTN videoconference/webcast education sessions:

7. Development of rehab intensity newsletters: July 2015 edition and December 2015 edition

8. Development of stroke rehabilitation intensity pocket cards (Revised September 2017)

9. Literature Review:

10. Development of a whiteboard video on rehabilitation intensity (January 2016)

11. Survey to evaluate resource needs to support implementation of rehab intensity data collection- Stroke Congress Poster ( September 2015)

Additional Documents/Tools

As part of a sustainability plan, resources will be developed by CorHealth Ontario’s Rehabilitation Coordinators Group and will be housed in this section.

Currently there are no resources in this section

If you would like more information on the resources used to support the development of this work please contact service@corhealthontario.ca

Regional Use of PIWP Deliverables

Region Description of Use Contact Name Contact Email Additional Information
Central East
  • Implement best practices
  • Improve current program
  • Perform needs assessment
Donelda Sooley cesn@rvh.on.ca
service@corhealthontario.ca
  • Educational and implementation resources including webinars, communiques, pocket cards, etc. were disseminated to support knowledge translation and implementation of Rehabilitation Time data collection.
  • Rehab Coordinator met with teams at each of the 10 inpatient rehabilitation facilities in the region to have initial dialogue, increase understanding, understand barriers and current practices and brainstorm opportunities.
  • The 10 inpatient rehabilitation facilities were brought back together for a regional forum on Rehabilitation Intensity which included a rehab expert speaker, implementation examples from other organizations, and Quality Improvement methodologies led by Health Quality Ontario.
  • Ongoing support for improvement of rehabilitation intensity has been offered; ongoing feedback regarding current status has been delivered.
Central South
  • Implement best practices
  • Improve current programs
  • Improve patient outcomes
  • Evaluate current programs
Darlene Venditti venditti@hhsc.ca
service@corhealthontario.ca
  • Central South has undergone region wide implementation of QI initiatives related to data capture and optimization of rehabilitation intensity. Specific QI initiatives vary from site to site.
Champlain
  • Implement best practices
  • Improve current program
  • Improve patient outcomes
  • Perform needs assessment
  • To evaluate current programs
Rehab Coordinator rehabcoord@champlainregionalstrokenetwork.org
service@corhealthontario.ca
  • Initially we used communiques, pocket card, slide decks etc. to support KT on RI in region. The attention given to RI by the PIWP and RC groups encouraged Champlain to complete a region-wide QI project on increasing RI at our 6 hospitals that deliver stroke rehab (2015/16). In 2016/17 most hospitals sustained the RI QI culture. RI for 6 hospitals is monitored quarterly by a stroke rehab sub-committee..
Northeastern Ontario
  • Implement best practices
  • Develop business case
  • Improve patient outcomes
Jenn Fearn jfearn@hsnsudbury.ca
service@corhealthontario.ca
  • When our Regional Network conducted a financial analysis of current state of stroke care compared to best practice state in collaboration with a consultant (Jan-Mar 2017) the rehab intensity principles were applied.
  • Similarly in Timmins and North Bay, rehab intensity principles were taken into consideration with the development of their integrated stroke units.
  • With the development of the acute stroke unit at Health Sciences North, the rehab intensity resources were used to educate the staff on the principles of rehab intensity as they will be providing weekend coverage on the intensive rehab unit
Northwestern Ontario
  • Implement best practices
  • Improve current program
  • Improve patient outcomes
  • Provide new hire orientation
  • Evaluate current programs
Esmé French frenche@tbh.net

nwostroke@tbh.net
service@corhealthontario.ca

  • The deliverables have been invaluable in educating administrators and clinicians when RI data collection was made mandatory. Ongoing webinars, FAQ documents and Communiques support continued ongoing staff education, quality improvement initiatives and program evaluation.
Southeastern Ontario
  • Implement best practices
  • Evaluate current programs
Stroke Network of Southeastern Ontario StrokeNetworkSEO@KGH.KARI.NET
  • Educational resources/webinars were used by RC and sites across region to support their implementation of Rehabilitation Time data collection. As materials were released throughout the PIWP cycle they were used to support the process as it was timely to the launch of the new data measure. The PIWP group responded to feedback throughout the development and adjusted the resources available.
Southwestern Ontario
  • Implement best practices
  • Improve current program
  • Improve patient outcomes
  • Evaluate current programs
  • Other
Lyndsey Butler lyndsey.butler@lhsc.on.ca
service@corhealthontario.ca
  • Used the PIWP to support education, resulting in strategies to implement rehabilitation intensity and improve patient outcomes ( i.e., A region-wide Rehabilitation Intensity Forum took place in 2015, dissemination of OSN communiques on Rehabilitation Intensity, promotion and attendance at webinars and stroke rounds on rehabilitation intensity, and promotion of QBP Resource Centre on Rehabilitation Intensity).
Toronto Stroke Networks
  • Implement best practices
  • Improve current program
  • Improve patient outcomes
Sylvia Quant sylvia.quant@sunnybrook.ca
service@corhealthontario.ca
  • To support stroke best practices, improve data quality and enhance rehab intensity (RI) provision within the TSNs’ rehab sites (Bridgepoint Sinai Health System, Providence Healthcare, Scarborough and Rouge Hospital-Centenery Site, St. John’s Rehab, Toronto Rehab, West Park Healthcare Centre). The Toronto Stroke Networks (TSNs) have been using the RI PIWP deliverables (standard education, resources and RI calculations) to inform and support local planning with respect to the provision of rehab intensity, RI data collection/reporting, staff education.
  • Leveraging the RI PIWP deliverables has led to the development of standard approaches in collecting and reporting RI amongst rehab sites within the TSNs, standard RI data quality indicator definitions, and a novel quality assurance framework that has been used by sites to support quality improvement. Rehab sites have developed RI internal reports and reporting processes to provide feedback to staff to improve RI data quality. RI PIWP education and resources have been used by rehab sites to support staff orientation and ongoing education.
West GTA
  • Implement best practices
  • Improve current program
  • Improve patient outcomes
  • Improve access
Janine Theben Janine.Theben@THP.ca
service@corhealthontario.ca
  • The Rehab Intensity PIWP information has been shared with all our regional partners. Still in initial phase of KT.
CorHealth Ontario

Health Quality Ontario; Ministry of Health and Long-Term Care. Quality-based procedures: clinical handbook for stroke (acute and postacute). Toronto: Health Quality Ontario; 2016 December. 132 p. Available from: http://www.hqontario.ca/evidence/evidence-process/episodes-of-care#community-stroke.