• Key Contacts

    For further information on this project, please contact the following staff who were previously part of the West Metro Vaccination Program:

    • Marlies Wanasili
  • Acknowledgements

    ESD and CBR (Community Based Rehabilitation) teams

    Chronic and Complex Care Divisional Directors

Video Abstract

Click on the following image to view a short video abstract of this project.

Background

Early Supported Discharge (ESD) is recognised as best practice in the Stroke clinical guidelines. Whilst current literature is focused on the efficacy of ESD for stroke survivors, little is known regarding its efficacy for other neurological conditions.

Aim

  1. Development of an Early Supported Discharge program for clients with neurological conditions e.g. stroke, Parkinson’s disease, Functional Neurological Disorder, Acquired Brain Injury
  2. Implementation and evaluation of ESD program at Western Health

Methods

Literature review and benchmarking was conducted with like services. Following scoping with stakeholders an inpatient model of care was developed. Better@home funding successfully obtained and new Allied Health positions were created including an Early Supported Discharge Coordinator.

Outcomes

Development of an inpatient bed substitution rehabilitation model including 10 virtual ward beds. 160 clients have been admitted to the program since launch date until August 30th 2022. Common diagnoses accepted: Stroke (n=103), PD (10), FND (6), MS (3), Other neurological conditions e.g. encephalitis, hypoxic brain injury post cardiac arrest (28).

FIM scores improved by 12.69 (stroke), 10.4 (other neuro), 17 (FND), 7.1 (PD), 15 (MS). Referrals received across the Western Health service including: acute (n=73), inpatient rehabilitation (63), aged care (12). Referrals also accepted from external health service, Melbourne Health to assist with access and flow demands (n=8).

Raw outcome measure data showed improvements in:

  • Quality of life average increase (EQ-5D-5L): 2.86 (66 patients).
  • Health rating scale: 14.90 (62 patients).
  • Carer Strain Index: 2.33 (39 patients).

Average length of stay: 17 days. 20 clients represented to Emergency and 10 clients did not complete program.

Conclusion

Provision of an Early Supported Discharge program has demonstrated value in improving functional outcomes for all neurological clients. Additional benefits include timely access to rehabilitation through the provision of an alternative interdisciplinary rehabilitation model.