The Network has released an updated repatriation policy for rehabilitation patients that require admission to acute care. The policy, which was developed with acute care and rehabilitation hospitals, will enhance flow and reduce inefficiencies.

A survey and data review revealed that the 2010 bed holding policy was not being applied consistently. It was also inefficient: Between April and November 2016, bed holding across the GTA resulted in 80-299 actual or projected lost bed days for low intensity rehab programs and 280-842 for other complex continuing care (CCC) programs.

The updated policy shifts the focus from prescribed timelines and criteria for bed holding to releasing beds when patients are admitted to acute care for assessment or treatment. The change will maximize occupancy of rehab/CCC beds across the system. It will also reduce the risk of patients being sent back without advance notice and confirmation that required medications and other resources are in place.

Key elements of the policy include:

  • Rehab/CCC beds will not be held when patients are admitted to acute care (in most cases).
  • Patients are given priority for readmission to the same rehabilitation program/service if their care needs have not changed and they continue to meet the criteria for the program.
  • Beds will be held for patients who are transferred to acute care but are not admitted (e.g., they are being seen in ER or for an outpatient consultation).
  • Beds will be held for patients in high intensity rehab programs for up to 48 hours when they have a planned admission to acute care. (As per current policy.)
  • Consideration will be given to holding beds for patient populations with specialized care needs (e.g., bariatric, haemodialysis, psychogeriatric). (As per current policy.)
  • Regular and ongoing inter-hospital communication is required to discuss the patient’s status, progress and readiness for return. Acute care must obtain prior approval before the patient is repatriated.

The updated policy is available here. For more information, contact Sue Balogh, Project Manager, at sue.balogh@uhn.ca.