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Restructuring a Rehabilitation Program for Older Adults: Effects on Patient Outcomes and Staff Perspectives

Published online by Cambridge University Press:  01 February 2013

Jennifer Klein  and
Tammy Hopper
Jennifer Klein*
Affiliation:
University of Alberta
Tammy Hopper
Affiliation:
University of Alberta
*
*Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Jennifer Klein, Ph.D. Senior Research Consultant, Specialized Geriatrics Glenrose Rehabilitation Hospital 11515 77 Avenue Edmonton, AB T6G 0M2 (jennifer.klein@ualberta.ca)
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Abstract

The purpose of this mixed-methods research study was to examine the impact of organizational change on patient outcomes and staff experiences in a rehabilitation program for older adults. Program restructuring focused on reducing patient length of stay and increasing admissions to the rehabilitation program. Study findings revealed that patients admitted after restructuring, as compared to the time period just prior, experienced shorter lengths of stay yet made similar progress towards rehabilitation goals. The average discharge Functional Independence Measure (FIM) scores between the two time periods were not significantly different. Yet FIM efficiency scores improved after the restructuring. With this reorganization, rehabilitation staff reported working harder to help patients achieve satisfactory outcomes, although initially staff reported lower morale. Findings extend the current literature and have practical implications for health care professionals interested in facilitating successful organizational change.

Résumé

L’objectif de cette étude utilisant des méthodes mixtes était d’examiner l’impact du changement organisationnel sur les résultats pour les patients et les expériences du personnel dans un programme de réadaptation pour les personnes âgées. La restructuration du programme a mis l’accent sur la réduction de la longueur du séjour des patients et l’augmentation de l’admission dans le programme de réhabilitation. Les résultats de cette étude ont révélé que les patients admis après la restructuration, par rapport à la periode avant cette restructuration, ont connu des séjours plus courts, et pourtant ont réalisé des progrès similaires vers la réadaptation. Les scores moyens à la décharge, Mesure d’indépendence fonctionnelle (MIF), ne diffèrent pas significativement entre ces deux périodes. Pourtant, les scores d’efficience MIF sont améliorés après la restructuration. Avec cette réorganisation, le personnel de réadaptation ont déclaré travailler plus fort pour aider les patients à obtenir des résultats, même si, au départ, le personnel a signalé un abaissement de moral. Ces résultats étendent la littérature actuelle et offrent des implications pratiques pour les professionnels de la santé qui sont intéressés à faciliter le changement organisationnel réussi.

Keywords

vieillissmentla réadaptationgériatriquepersonnes âgéesrestructuration des soins de la santéagingrehabilitationgeriatricolder adultshealth care restructuring
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 32 , Issue 2 , June 2013 , pp. 185 - 194
Copyright
Copyright © Canadian Association on Gerontology 2012 

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