Rehabilitation Intensity

• Implement best practices
• Improve current program
• Perform needs assessment

• 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.

• Implement best practices
• Improve current programs
• Improve patient outcomes
• Evaluate current programs

• 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.

• Implement best practices
• Improve current program
• Improve patient outcomes
• Perform needs assessment
• To evaluate current programs

• 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..

• Implement best practices
• Develop business case
• Improve patient outcomes

• 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

• Implement best practices
• Improve current program
• Improve patient outcomes
• Provide new hire orientation
• Evaluate current programs

nwostroke@tbh.net
oh-corh_service@ontariohealth.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.

• Implement best practices
• Evaluate current programs

• 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.

• Implement best practices
• Improve current program
• Improve patient outcomes
• Evaluate current programs
• Other

• 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).

• Implement best practices
• Improve current program
• Improve patient outcomes

• 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.

• Implement best practices
• Improve current program
• Improve patient outcomes
• Improve access

• The Rehab Intensity PIWP information has been shared with all our regional partners. Still in initial phase of KT.