Introduction: In 2017, we started to implement LOS benchmarks based on RPGs in our inpatient stroke rehabilitation program.  Prior to this, each patient used to stay in the inpatient program for 6-8 weeks.  Our goal was to identify the barriers which interfered with following those benchmarks for each patient.

Methods: We started with education of our rehab team about the importance of optimizing resource allocation and efficiency of stroke rehab delivery. During weekly team rounds, we determined the LOS benchmarks for each new admission based on their RPG. Following discussion with our rehab team, it was determined if the assigned benchmark LOS could be followed, or if there were barriers to delay the discharge date. We kept track of the most common reasons causing delayed discharge dates.

Results: The implementation of RPG LOS benchmarks improved our median LOS and in Sept-Dec 2017 comparing to the same months in 2016, 37.5 versus 55 days. Average Functional Independence Measure (FIM) Efficiency was 0.77 in Sept-Dec 2017 (Median: 0.76). It was 0.51 in   the same months in 2016 (Median: 0.44).    The most common barriers for not following LOS benchmarks in our rehab services were being a rural resident, limited family support and lack of outpatient services. 

Conclusion: Resource allocation improvement in stroke rehab services is achievable using LOS benchmarks, however barriers like geographic differences, family support and optimal access to outpatient rehab need to be addressed to ensure the success of this implementation.

Barriers in Implementing Rehab Patient Group (RPG) Length of Stay (LOS) Benchmarks in an Inpatient Stroke Rehab Setting.