Development of Rehabilitation "Fast Track"

Research Objectives: To determine if utilizing a rehabilitation “fast track” for select stroke patients provides quicker access to outpatient therapy in a rural setting.

Design: Case Study

Setting: Transition from inpatient to outpatient rehabilitation therapy among selected stroke survivors in northern Nevada, covering an expansive area of 100,000 square miles served by a single healthcare provider.

Participants: 71 YO female with a right basal ganglia embolic stroke resulting in left sided weakness. Due to emerging volitional motor movement with the potential to translate into improved function the patient qualified for “fast track” outpatient rehabilitation after discharge from acute inpatient rehabilitation.

Interventions: “Fast track” outpatient rehabilitation is based off patient cancelations with the goal of improving time to treatment.

Main Outcome Measures: Number of weeks in between date of discharge from inpatient rehabilitation and date of evaluation in outpatient rehabilitation.

Results: Standard track averaged wait times in Occupational therapy (OT) are 2 weeks while Physical Therapy (PT) averaged 8 weeks. Fast track wait times for OT were 2 weeks and PT was 1 week. This is a difference of 0 weeks for OT and 7 weeks for PT.

Conclusions: This developed “fast track” reduced wait time for outpatient PT by 87.5%. No improvement was seen in outpatient OT wait times. This “fast track” enabled continued intensive rehabilitation in the first 8 weeks after initial stroke which corelates with 5-year outcome post stroke[1]. The current “fast track” is based off patient cancelations which require families and patients to be flexible. It also works better when standard therapy wait times become longer as it gives more time for cancellations to occur. In conclusion, a cancelation based “fast track” is effective in getting patient into therapy sooner, especially when standard wait times are long.

Author(s) Disclosures: No conflicts of interest