37 Strategic interventions to enhance return-to-work success rate at adult day-care rehabilitation unit: a comprehensive approach for improvement

Background The employment status after neurological injuries was a concern for the patient and family, it affects multiple aspects of quality of life including physical, social and financial aspects.¹ Many patients complained about their ability to return to their jobs, the Adult Daycare Rehabilitation (ADR) team checked the percentage of patients who were able to return to work. The Return-To-Work (RTW) program was initiated in 2021 but the percentage was low (60% in the second half of 2022). This Quality Improvement (QI) project was developed to improve the results of the return-to-work program using Quality Improvement tools. The aim was to improve the percentage of patients who returned to work successfully after completing the RTW rehabilitation program from 60% to 80% by the end of 2023.

Methods Incorporation of the return-to-work multidisciplinary rehabilitation² and the Institute for Healthcare Improvement Model of Improvement using Plan-Do-Study-Act (PDSA) cycles and QI tools such as cause-and-effect diagram, driver diagram, prioritisation matrix, and Pareto chart³. The RTW program has two phases, the first phase is vocational rehabilitation which includes training inside the unit, while the second phase includes worksite assessment and developing return to work recommendations and accommodations (figure 2). The outcome measure was the percentage returned to their work (figure 1).

Results Percentage of patients returned to work following completion of the RTW program showed signs of improvement after PDSA cycle 1, remaining above the target of 80%.

Conclusion The use of QI tools focused effort and improved the results of the return-to-work rehabilitation program. These tools helped to address the points of defects at the beginning and helped the team achieve a percentage above 80%.

References

1. Maaijwee, NAMM, Rutten-Jacobs LCA, Arntz RM, Schaapsmeerders P, Schoonderwaldt HC, Dijk EJ van, Leeuw F-E de. (2014, September 23). Long-term increased risk of unemployment after young stroke. Neurology. https://doi.org/10.1212/WNL.0000000000000817

2. Awang H, Tan L, Mansor N, Tongkumchum P, Eso M. Factors related to successful return to work following multidisciplinary rehabilitation. Journal of Rehabilitation Medicine 2017;49(6):520–520. https://doi.org/10.2340/16501977-2233

3. Crowl A, Sharma A, Sorge L, Sorensen T. (2015, August). Accelerating quality improvement within your organization: applying the model for improvement. Redirecting. https://doi.org/10.1331/JAPhA.2015.15533

Ethical Approval/IRB Statement This project has been approved by the Director of Adult Day-care Rehabilitation unit, hospital leadership, and Quality and Patient Safety department in Qatar Rehabilitation Institute.

Disclosures and Acknowledgements All authors have nothing to disclose.