Releasing time to care: a quality improvement project aimed to increase direct rehabilitation time in a Stroke Rehabilitation Centre

 But did that extra therapist time result in better recovery of survivors? By not answering that question, this was COMPLETELY FUCKING USELESS!

Releasing time to care: a quality improvement project aimed to increase direct rehabilitation time in a Stroke Rehabilitation Centre

Dolores Macchiavello , 1 Jennifer Blackhouse,2 Jennifer Clark,2 Claire Haddock,2

James Hinder,2 Benjamin Jelley,2 Amy Joyce,2 Kate Matchett,2 Eden Morris,2

Carys Moss, 2 Chris Rees,2 Alun Walters,2 Susan White2

To cite: Macchiavello D,

Blackhouse J, Clark J, et al.

Releasing time to care: a quality

improvement project aimed to

increase direct rehabilitation

time in a Stroke Rehabilitation

Centre. BMJ Open Quality

2024;13:e003043. doi:10.1136/

bmjoq-2024-003043

Received 1 August 2024

Accepted 11 December 2024

1

Shaping Change, NHS Wales

Cardiff and Vale University

Health Board, Cardiff, UK

2

Cardiff and Vale University

Health Board, Cardiff, UK

Correspondence to

Dolores Macchiavello;

dolores. macchiavello@ wales.

nhs. uk

Quality improvement report

© Author(s) (or their

employer(s)) 2024. Re-use

permitted under CC BY-NC. No

commercial re-use. See rights

and permissions. Published by

BMJ Group.

ABSTRACT

Stroke is a leading cause of disability among adults, and

any treatment that improves functional outcome, like

higher intensity of rehabilitation therapy, can significantly

reduce its financial burden. Clinicians on a stroke

rehabilitation ward are expected to track and nationally

report on rehabilitation time to contribute to the Sentinel

Stroke National Audit Programme (SSNAP), a process

that was manual, paper-based, time- consuming and

redundant, which in turn impacted on a reduction in

clinical time to provide stroke rehabilitation. We aimed

to release 20% of clinical time by reducing inefficiencies

within their time management and reporting process,

ensuring that clinicians had more time available for direct

patient care. To do so, we developed a tool to gather and

analyse SSNAP-specific data and use Kanban cards to

make weekly actions visible to reduce miscommunication.

As a result, the whole occupational therapists team

gained 7.5 hours a month (25% of released time, 12 extra

additional therapy sessions available) when improving

their data gathering and analysis process. A specialist

physiotherapist saw a 2 hour a month gained and 4 hours

a month gained for a Physiotherapist. Dietitians also saved

3 hours a month by not having to duplicate information.

This process is part of a key organisational requirement

for clinical teams working with stroke patients admitted to

hospital and by addressing some inefficiencies, we were

able to impact on direct patient care(NOT RECOVERY!).