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Exploration of a Community Rehabilitation Centre’s Healthcare System

Figure 1 MNCRC Health System Concept Map

Within the dynamic landscape of the global health industry, development of an interconnected healthcare system has formed an essential component of success, overcoming the ever-growing, unsustainable demand for health-related resources (Plack et al., 2019). Formation of interconnected health systems is essential for improving health outcomes, as adaptions made to components of the system foreshadow improved efficiency in the provision of holistic care delivery (Lao et al., 2021).

‘MN’ Community Rehabilitation Centre (MNCRC) provides an allied health focused day therapy program for geriatric Australian’s requiring slow-stream rehabilitation following a hospital admission at a Queensland Health (QH) hospital. Once accepted, consumers are admitted into a specific-specialty ward based on their presentation where they receive 24-hour medical management in conjunction with individualised allied health rehabilitation within the day therapy program. Given the vulnerability of elderly people, it is essential that this healthcare system operates efficiently to enhance their health and safety for discharge. A concept map of the MNCRC healthcare system is depicted in Figure 1, which has been colour-coded to represent the interconnected relationship between the four key elements of a healthcare system forming the foundational construct supporting service provision (Placket al.,2019)

MNCRC’s healthcare system is influenced by a multitude of stakeholders and contextual elements. The system requires robust partnerships with QH to acquire specialised allied health practitioners capable of providing high-quality care. Within the day therapy program, clients complete an individualised program guided by multidisciplinary teams (MDT) to target impairments based on the client’s goals. MNCRC receives funding from the State Government in conjunction with Medicare to finance the healthcare provision.

A characteristic strength of MNCRC’s healthcare system is the strong MDT relationships evident by the emphasis placed upon regular meetings in conjunction with key stakeholders as highlighted in blue (Figure 1). This collaborative staff culture is an integral aspect of successful healthcare systems, instigating the cohesion of team and client goals to address impairments (Girardi et al., 2020). Strongren et al., (2016) supports this, stating that clinical relationships with MDTs and stakeholders directly influences care output and overall consumer satisfaction. Coherent collaboration of MDTs is evident in the day therapy program through the collaborative delivery of clinical programs and is continued weekly to ensure the delivery of best practice care focused on client goals (Lao et al., 2021).

This regular collaboration of MDTs with clients and stakeholders foreshadows positive client outcomes due to the individualised nature of care provision (Strongren et al., 2016). Figure 1 emphasises the importance of delivering speciality services based on individual impairments and goals. This is supported by Girardi et al., (2020), stating that individualised care planning, delivered with a MDT focus directly correlates with improved patient satisfaction and outcomes, accelerated recoveries and reduced chronicity development. This application of client centred care can assist in reducing public waitlists, as clients achieve discharge criteria more efficiently through individualised care delivery.

A fundamental weakness within the MNCRC healthcare system is evident in their lack of technological resources for appropriate client follow-up following discharge as coloured in green (Figure 1). Once discharged, it is expected that clients follow up for the subsequent three months, to monitor outcomes and to collect long-term performance data. This opportunity is limited for clients residing in rural areas, leading to significant disparities in care accessibility. Adapting discharge systems to include Telehealth services has been proposed however funding has been rejected. Whilst rural consumers still gain the benefits of completing the program, the long-term benefits such as consumer satisfaction and performance data is compromised without a structured Telehealth system.

References

Girardi, De Gennaro, G., Colizzi, L., & Convertini, N. (2020). Improving the Healthcare Effectiveness: Systems-thinking. Electronics (Basel), 9(6), 884. https://doi.org/10.3390/electronics9060884

Lao, Wilesmith, S., & Forbes, R. (2021). Mentorship of physiotherapists: a qualitative study. Physiotherapy Theory and Practice, 1–10. https://doi.org/10.1080/09593985.2021.1917023

Strongren, Eriksson, A., & Dellve, L. (2016). Social capital among healthcare professionals. Journal of Nursing Studies, 53(January), 116–125. https://doi.org/10.1016/j.ijnurstu.2015.07.012

Plack, Goldman, E. F., Scott, A. R., Thompson, T., & Brundage, S. B. (2019). Systems Thinking and Systems-Based Practice Across the Health Professions: An Inquiry into Definitions, Teaching Practices, and Assessment . Teaching and Learning in Medicine, 30(3), 242–254. https://doi.org/10.1080/10401334.2017.1398654

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