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Rehabilitation is aimed at enabling people disabled by injury or disease to obtain their optimal physical, intellectual, psychological and social functioning. It requires an integrated team of health professionals using a bio-psycho-social model of health across the continuum of care. An aging population, emphasis on chronic disease management, and the move towards community living for people with disabilities requires the re-evaluation of rehabilitation services. The purpose of the Rehabilitation Gaps and Needs Assessment was to outline existing rehabilitation services, identify areas to improve care, and to provide the foundation for a strategic plan for rehabilitation within Eastern Health. Due to the tertiary role of Eastern Health, provincial input was sought and some recommendations made for other health authorities that would help improve services throughout the province. -- Primary data was gathered from patients, families, managers, administrators, and rehabilitation providers using surveys, focus groups and key informant interviews. Secondary data was analyzed from provincial and regional health indicators and databases, previously completed human resources and rehabilitation reports, and rehabilitation reports from other provinces. The research process and results were directed by community stakeholders, managers and other experts in the field. -- The results showed that, other than the physical facilities, existing inpatient and outpatient services at the L.A. Miller Centre were adequate overall. The greatest need identified was community-based rehabilitation; rehabilitation in homes, long term care facilities and personal care homes. Findings suggested that there is a need for inpatient restorative care for the elderly, for community-based management programs for people with chronic disease (cardiac, pulmonary, arthritis, obesity, etc.) and for vocational and cognitive rehabilitation for people with brain injury. Access to rehabilitation is polarized along rural and urban lines with rural areas having very limited access to inpatient, outpatient and community rehabilitation. We found that for people with rehabilitation needs, over half were readmitted to hospital within a year. There were 19,418 alternate level of care days for rehabilitation patients in 2005-2006. Gaps in rehabilitative care cause impairment in patient flow through the system and ultimately limit the person’s ability to live independently at home. These substantial improvements in rehabilitation services would require an action plan over a period of 5-6 years. -- There are ways to improve recruitment and retention of rehabilitation providers, including therapists, nurses and physical medicine and rehabilitation specialists across the province. There are also methods such as reducing clerical duties and improving health record and patient information technology that have the potential to improve efficiency. -- We found that gaps in the system can be improved through enhanced communication, patient navigation and development of a coordinated provincial rehabilitation network. Admission criteria designed to identify the most appropriate patients for a service, especially at the L.A. Miller Centre, causes confusion for health providers, patients and families and ultimately creates gaps. It is essential that we avoid a silo approach to care and ensure that patients and their families find the most appropriate rehabilitation service for them.
|Item Type:||Report (Project Report)|
|Department(s):||Medicine, Faculty of|
|Date:||26 June 2009|
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