Impact of delayed access to inpatient rehabilitation service for multi-trauma patients

Overview

Initiative type

Model of Care

Status

Deliver

Published

June 2026

Summary

This project investigates factors influencing delays, to compare the outcomes of trauma patients with longer waiting with those who had relatively shorter waits, and to explore the strategies to promote early referral and access.

Dates: January 2024 - October 2025

Implementation sites: Cairns Hospital

This project was presented as a poster at CEQ Showcase 2026 (PDF, 388KB).

Aim

This study aims to examine the potential impact of the delayed access to inpatient rehab  on functional recovery and hospital length of stay. This would be important for exploring the potential strategies for improving wait times to promote early access and better patient outcomes.

Outcomes

Eight patients were identified. Patient baseline characteristics were compared. We hypothesised  that the delayed access to inpatient rehab could potentially be associated with delayed recovery, longer hospital length of stay, increased complications and reduced functional outcomes. The factors causing delays might include delayed referrals, the perception  of health professionals on the accessibility of inpatient rehab service, limitations in rehab bed availability, acute medical issues including uncontrolled pain, patients’ disruptive behavior with inconsistent engagement and government support. The potential  strategies for improving wait times could be standardized referral process, variable rehab services including in-reach model of care.

Background

Multi-trauma patients who could access to inpatient rehabilitation program earlier have  been suggested to have better patient outcomes, shortened rehabilitation length of stay, fewer readmissions, and potentially cost-effectiveness (Sirois et al., 2004; DaVanz et al., 2014). Some evidence has shown that delayed transfer to intensive inpatient  rehabilitation services for stroke and traumatic brain injury may result in reduced functional independence and poorer functional outcomes (He et al., 2025; Bradley & Wheelwright, 2024).

Methods

This is a retrospective cohort qualitative study. Patients with multi-trauma injuries  who were admitted to inpatient rehabilitation ward were identified from June 2024 to October 2025 in the regional hospital in North Queensland. Baseline characteristics and the mean wait times from acute admission to the rehab referral and to admission to  the rehab ward were obtained from patient intake charts.

Main outcome measures were length of stay, functional independence measure on admission and discharge, interruptions in rehabilitation, and discharge destination.

Discussion

This study would be valuable for promoting early comprehensive rehabilitation care in  multi-trauma patients. It provides initiatives for further prospective studies on the trials of difference rehab model of care and structured referral pathway to improve wait time and patient outcomes in the regional hospitals.

References

1. Neferu, R. & Fleck, R. (2024). Reducing wait times for access to inpatient rehabilitation  for patients with acquired brain injury: a quality improvement initiative. BMJ Open Quality 2024;13:e002915. doi:10.1136/bmjoq-2024-002915 2. Bouman, A. et al. (2017). Effects of an Integrated `Fast Track' Rehabilitation Service for Multi-Trauma Patients:
A Non-Randomized Clinical Trial in the Netherlands. PLoSONE 12(1): e0170047. doi:10.1371/journal.pone.0170047

Key contact

Dr Wei Qu

Rehabilitation Physician

Cairns and Hinterland Hospital and Health Service

Email: wei.qu@health.qld.gov.au