Maximising Ability, Reducing Disability. Dr. Áine Carroll Clinical Lead Valerie Twomey Programme Manager

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1 Rehabilitation Medicine Programme Maximising Ability, Reducing Disability Dr. Áine Carroll Clinical Lead Valerie Twomey Programme Manager 1

2 Quality, Access and Cost Quality: Reduce morbidity: Reduced pressure sores Reduced contractures Reduced fractures Increase continence Reduce discharge to nursing home by 10. Increase numbers returning to work by 2% (16% from 18%) Reduce Carer distress by a 10 point reduction in Carer Burden Scale Access: 80% access to early Rehabilitation Medicine assessment within 2 weeks of referral (currently 40%) Reduction in waiting time to specialist assessment by 14 days (current average 27 days) 80% access to admission to specialist inpatient rehabilitation beds within 60 days (current average 70) Reduction in waiting list to complex specialist rehabilitation by 20% from 120 to 100 days in 1 year Reduction in delayed discharges from complex specialist rehabilitation to 8% (currently 10% of all admissions) Cost: Reduced length of stay (LOS) in acute hospital beds by 5 days. (60-55) Reduced length of stay (LOS) in complex specialist rehabilitation hospital beds by 5 days (64-59). 10% reduction in readmission and attendance at ED rate 5% reduction in care requirements 2 Reduction in DRS by x 1 point = 30,732.37per person Reduction in discharge to nursing home by 10.

3 HSE Service Plan 2012 HSE Service Plan 2012 Key Result Area Deliverable Output 2012 Target Completion Quarter Hospital Services: Rehabilitation Clinical Programmes Develop regional networks, local rehabilitation teams and associated protocols, Q1 pathways and bundles In association with other programmes (e.g. Stroke, Care of the Elderly) define Q2 an enhanced model for community based rehabilitation services Disability Services: Neuro-Rehabilitation Strategy Service Provision and Total Work with the Rehabilitation Medicine Programme to support the development Ongoing Reconfiguration of an implementation plan based on the recommendations of the National Neuro- Rehabilitation Strategy Establish Regional Rehabilitation Networks Q2 Commence development of regional inpatient rehabilitation facilities Q3-Q4 3

4 Rehabilitation Medicine Programme Model of Care ED Acute Rehab Self Management Acute Services SERVICE USER Health Promotion & Prevention Primary Care Team Community Rehab Team Regional Rehab National Rehab 4 Community Leisure Support Services Screening and PC Level Rehabilitation Services Specialised Rehabilitation Therapy in Community Inpatient Specialised Rehabilitation Services Rehabilitation for Low Incidence and Complex Conditions

5 KRA1&4: Managed Clinical Rehabilitation Networks (MCRNs) A linked group of health professionals and organisations from primary, secondary, and tertiary care, working in a coordinated way that is not constrained by existing organisational or professional boundaries to ensure equitable provision of high quality, clinically effective care... The emphasis...shifts from buildings and organisations towards services and patients. 5 Baker and Lorimer

6 Area of Development 2012 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec RAG Secure Agreement and Funding Appoint Clinical Lead and Project Manager and secure Administrative Support Identify and Appoint Project Team Draft Development Plan Project Team Work Newsletter Production Establish Working Groups Patient Involvement Working Group Progress Protocol and Document Production Open Meeting Consultations Finalise Quality Assurance Programme Appoint Lead Clinician and Transfer Project Staff 6 Launch MCRN

7 KRA3: National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland Area of Development Launch of National Policy and Strategy 2012 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec RAG Engagement with National Disability Services NP&S Steering Group Meetings 7

8 KRA5: Development of Regional Inpatient Rehabilitation Units A single managed network for neurorehabilitation services will span each of the 4 HSE Regions, covering a population of approximately 1 million people. The network will facilitate consistent adherence to national standards, protocols and defined care pathways. RMP Model of Care 8

9 Deliverables Produced Key program deliverables a)model of care due for consultation with other Programmes b)care Pathways: ABI; SCI; Prosthetics and Orthotics; Progressive Neurological Conditions - Draft c)national Clinical Guidelines - Draft 9

10 Key Milestones: Jan Dec 2012 Task/Activity Quarter 1 Quarter 2 Quarter 3 Quarter 4 Person(s) Responsible Develop Regional Managed Clinical Rehabilitation Networks (MCRNs) Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Clinical Advisory Group; Working Group Identify, develop and initiate pathways and care bundles Appoint 2 Regional Rehabilitation Medicine Consultants per region Working Group Clinical Lead Appoint 2 Liaison Coordinators per region Clinical Lead Set up Regional Project Teams Appoint Allied Health Professional posts per region Project Manager Clinical Lead Cross Programmatic Steering Group 10 Project Manager

11 Issues for Discussion Business Case Submission November 2011 Procurement of Prosthetics and Orthotics Metrics for the Programme 11

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