Time is Function: A Physician Quality Improvement Project
After medical stabilization, earlier stroke rehabilitation is important for optimal recovery. Led by Dr. Evan Kwong, the aim of this quality improvement (QI) project is to improve the patient access to inpatient stroke rehabilitation – the current regional rehabilitation target is 14 days after admission to an acute hospital.
Holy Family Hospital has a long history of specialized rehabilitation for the older adult. Of the 65 inpatient rehabilitation beds, 30 are dedicated for neurological rehabilitation. Each year, approximately 180 patients are admitted for inpatient stroke rehabilitation from various areas of British Columbia.
The project started with a medicine unit at St. Paul’s Hospital. After the first Plan-Do-Study-Act (PDSA) cycle, the time to connect a patient with inpatient stroke rehab decreased from 22.5 to 20.2 days but this is not a clear significant trend. Length of stay in rehabilitation at Holy Family Hospital for the cases in the project decreased from 42.1 to 19.4 days, further helping to improve patient access. Work is now underway to examine the variability of the data, stroke outcomes, the next PDSA cycle, spread, and sustainability of the change initiatives.
Physician Led Quality Improvement (PLQI) is a quality improvement partnership among VCH, Providence and Specialist Services Committee (SSC) to strengthen the quality improvement capacity and culture within our physician community. Work is done collaboratively with Quality department colleagues and help physicians connect with operations and gain support from senior leadership. This project could not have been done without the support of Providence, the PLQI initiative, and the BC Patient Safety & Quality Council Summer Student Internship program.