Benefits of Centralized Scheduling in a Post- Acute Residential Rehabilitation Program for people with acquired brain lesions. A Pilot Study

Publication date: Available online 18 December 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Alec Vestri, Silvia Pizzighello, Sara Piccoli, Andrea Martinuzzi
ObjectiveTo verify if the use of a designated staff person to coordinate and schedule therapy services in a post acute residential rehabilitation program for people with acquired brain lesions results in a higher intensity treatment allowing the reaching of clinical outcome in a reduced length of stay. Cost saving and perceived satisfaction were explored.DesignThis nonrandomized retrospective study uses data collected relative to two different methods of scheduling: Self Planning in which each single team member makes appointments which are then displayed on a shared board, and Managed Planning in which appointments were made by a designated staff person.SettingThe study was conducted in a residential centre for people with post acute acquired brain lesions between 2009 and 2012.Participantsand main outcome measure: Patients of Managed Planning group (N=10) were balanced with patients of Self Planning group (N=10) on the basis of clinical and demographical characteristics. The sample of 20 patients was analysed using organizational measures (length of stay in rehabilitation, number of treatment hours and the total cost of rehabilitation), clinical outcome scales (Disability Rating Scale, Functional Independence Measure and Functioning and Barthel Index), perceived quality of treatment by patients (Questionnaire) and perceived satisfaction of team members (Job Descriptive Index).InterventionsNot applicableResultsAll patients improved on all clinical rating scales at the moment of discharge (all effect size are large). In the Managed Planning, number of treatment hours increased (Cohen's d = 2.15) resulting in reduced length of stay (Cohen's d = 0.95) and cost of rehabilitation (Cohen's d = 1.22); the quality of treatment perceived by the patients and their families increased while team member satisfaction did not change.ConclusionThe use of a designated staff person to manage therapy services improve efficiency and efficacy of a patient centered health care system. The proposed scheduling system results in a remarkable cost saving for the National Health System.



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