Implementation of a new goal-planning process in an intermediate neuro-rehabilitation unit

Purpose

It was recognised that this neuro-rehabilitation unit had a long length of stay for patients. This summary demonstrates how a new goal planning process was implemented on the unit. The aims of this new process were to reduce length of stay to the national average of 80 days, reduce the waiting list to 1 week, to consistently achieve greater than 70% patient and family/carer satisfaction and to ensure no adverse impact on the FIM/FAM outcome measure as a result of implementing the new process.

Approach

The new goal planning process was determined through liaison with the multi-disciplinary team. Regular meetings were held to maintain communication and information sharing to ensure the most appropriate process was determined and to ensure it was implemented as effectively and efficiently as possible.

Outcomes

The project enabled a smooth integration of the new goal planning process whilst taking into account individual and team traits. A SWOT and team roles analysis was carried out to ensure the team were engaged in the new process and took ownership of it to ensure its success and effectiveness.

Implications

The aim is for this new goal planning process to reduce length of stay from an average of 157 days to 80 days and increase the number of admissions from 53 to 120 per year reducing the waiting list to 1 week within 4 years.

Goal planning is recognised as an integral part of neuro-rehabilitation with multiple guidelines recommending its implementation within this area due to the increased effectiveness it produces on neuro-rehabilitation units. This new process will enable a more coordinated approach to rehabilitation maximising the unit´s effectiveness and efficiency and patient and family/carer satisfaction.

Top three learning points

  1. The importance of forward planning and good communication with all involved when implementing a new process.
  2. The value a robust goal planning process can have on the efficiency and effectiveness of a neuro rehab unit.
  3. The importance of evaluating a new process following its implementation to ascertain if any adaptations are required and whether it is achieving its intended purpose.

Fund acknowledgements

Manchester University Hospitals NHS Foundation Trust University of Salford

Additional notes

This work was presented at Physiotherapy UK 2018.