Rehabilitation service delivery: audit tool for best practice

2. Infrastructure

This is one of eight audit templates that form the Rehabilitation service delivery: audit tool for best practice.

This tool enables rehabilitation services to plan and review their practice to identify areas that will improve service delivery and patient outcomes. It can also be useful for teams involved in planning and establishing new rehabilitation services.

The responsibilities of the organisation and the service need to be rated. Some of the core elements are solely organisational responsibilities. Others are rehabilitation service responsibilities or dual responsibilities.

The template is for the local health district, specialty health network, affiliated health organisation and/or the private health provider of rehabilitation services. The organisation or rehabilitation service should complete the areas in the template that have been left unshaded. The people or team may vary depending on the service model and setting. For the best result, involve a range of staff in the discussions.

Core element rating scale

N/A	0	1	2	3	4
Not applicable	Not achieved	Rarely achieved	Sometimes achieved	Often achieved	Always achieved

Instructions

After discussing each core element with members of the working group, agree on the rating, and note the evidence to support this rating.

Use the action plans to note areas for improvement, key actions and who is responsible.

For more information about the audit tool, visit: https://aci.health.nsw.gov.au/networks/rehabilitation/resources/audit-tool

2. Infrastructure

Organisation/health service: Date:

Team/s:

No.	Core elements	Organisational rating N/A 0 1 2 3 4	Service rating N/A 0 1 2 3 4	Supporting evidence
2.1	Rehabilitation services and infrastructure are available across a range of settings to optimise patient flow and access based on client acuity and clinical need (e.g. in-patient, in-reach, day rehabilitation program, transitional living units, community rehabilitation, rehabilitation in the home, etc).
2.2	Rehabilitation infrastructure is designed in accordance with the Australasian Health Facility Guidelines and Australasian Faculty of Rehabilitation Medicine Standards for the provision of inpatient adult rehabilitation medicine services in public and private hospitals (2019).
2.3	Appropriate workspaces are available to support rehabilitation staff working in a flexible and multidisciplinary way.
2.4	Technology gaps are identified and assessed, with rehabilitation services provided with the opportunity to engage in the planning of solutions.
2.5	The organisation invests in, and implements, technology systems and solutions to enhance the provision of best-practice rehabilitation care.
2.6	The infrastructure and IT support is provided to enable the use of virtual care for telerehabilitation.
2.7	Appropriate equipment and technology are available for use across both organisation-based and community-based rehabilitation settings.
2.8	Single rooms are available in the inpatient settings where clinically indicated.
2.9	Transitional living units (TLU) and/or independent living units are available in the inpatient setting for the purposes of training independent living skills, self-management, carer training, discharge planning and facilitating efficiency in sub-acute bed management.
2.10	Dedicated private spaces are available for family and carer meetings.
2.11	An adequate number of dedicated office spaces are available for rehabilitation staff.
2.12	Access to pool cars and other forms of transport is provided to facilitate community access and facilitate safe and timely transition to home.
2.13	The physical rehabilitation environment is designed to facilitate individual rehabilitation programs and is tailored to meet physical, cognitive, emotional, social and spiritual needs and ensure safety. (Consider each care setting.)
2.14	The social aspects of the rehabilitation environment are designed to facilitate the client’s rehabilitation needs and ensure safety. (Consider each care setting.)
2.15	Cultural safety and inclusiveness are considered in the design of the rehabilitation environment. Refer to My rehab, my journey for suggestions.
2.16	Processes are in place to review the environment in which rehabilitation occurs as a client’s status changes. This may involve transition from one care setting to another.
2.17	In the inpatient and TLU settings, patients’ rooms are set up to encourage activities of daily living as part of rehabilitation.
2.18	In the inpatient and TLU settings, patients’ rooms simulate a home environment where possible.
2.19	Both clinical and recreational areas are used for the purposes of individual and group therapy, e.g. physiotherapy gym, bathroom areas, patient kitchen, outdoor gardens, etc.
2.20	In the inpatient setting, where possible, most of the therapy is undertaken/co-located in the general ward area (as distinct from standalone therapy areas located elsewhere).
2.21	In the inpatient and TLU settings, shared-living arrangements and small-group programs are used to: promote peer interactions learning transfer of skills to everyday living reinforcement of positive social behaviours.
2.22	Practice spaces that facilitate skill development (such as negotiating challenging physical environments) are available and used to support the client reaching their goals.
2.23	The community is accessed for the development of skills in everyday environments and situations, e.g. shopping and recreation.

Infrastructure action plan

Date:

Core element #	Area for improvement	Action/s	Person responsible	Due date

Published November 2023. Next review 2028. ACI/D23/3804 SHPN (ACI) 230798-2 ISBN 978-1-76023-656-4 [ACI_4923]
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