Reducing hospital length of stay with criteria-led transfer from the acute stroke unit to inpatient rehabilitation.

Abstract

Background: Criteria-led transfer allows transfer of select stroke patients to inpatient rehabilitation without rehabilitation physician review, which may be a barrier for timely transfers.

Objective: Primary: determine the proportion of patients transferred via criteria-led transfer and waitlist time. Secondary: determine the number of unplanned 30-day acute hospital representations and readmissions from inpatient rehabilitation, and number of daily allied health contacts while waitlisted.

Method: A single-centre retrospective analysis was conducted on all patients transferred from the acute stroke unit to inpatient rehabilitation in 2023.

Results: 178 (79%) patients successfully used criteria-led transfer, 22 (9.5%) did not meet criteria and the remainder attended inpatient rehabilitation via a separate pathway. Median waitlist time (in days) was shorter for criteria led transfer patients compared with those who did not meet criteria (3 (1-5) vs 5 (3-8), p=0.005). Emergency department representation rates were lower in the criteria-led transfer cohort (30 (16.9%) vs 8 (36.3%), p=0.03) compared with those who did not meet criteria. No difference in readmission rates was seen (p=0.22). Waitlisted patients received 1 (0.5-1.5) allied health reviews daily.

Conclusions: Criteria-led transfer is associated with shorter waitlist times for transfer to rehabilitation without increased adverse events. Further research is needed to determine result generalisability.