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Innovative rehabilitation programme START celebrates 10 years of success

Fuseworks Media
Fuseworks Media

The Waikato DHB’s award-winning rehabilitation service START (Supported Transfer Accelerated Rehabilitation Team) is celebrating 10 years of making a difference in the community.

The programme was a first for New Zealand, and has since been used by other DHBs as a blueprint for an innovative model of care.

START is part of the DHB’s Older Persons, Rehabilitation and Allied Health services, and supports patients over 65 who need rehabilitation to make a safe and quick transition from hospital to home.

The service begins shortly after the patient arrives home, when they often feel the most vulnerable and have the greatest need. They’re helped with setting up their home environment to achieve the best outcomes, including sorting out new prescriptions, setting up equipment and ensuring they have enough food.

START is unique in providing patient-centred care to help them return to the level of independence based on what is important to them.

A registered nurse, physiotherapist and occupational therapist work intensively with each patient on their home rehabilitation goals for up to six weeks following their stay in hospital or presentation at the Emergency Department.

For example, the patient may want to start going back to the library, so the team will include that as part of their individualised care plan.

A healthcare assistant can visit up to three times a day, seven days a week, to support the person to achieve those goals.

START has been proven to be have significant benefits for patients and the DHB. A randomised control trial found it significantly cut the length of stay in hospital, was cost-effective, halved the chance of readmission to hospital, prevented hospital admissions from the Emergency Department and improved patient satisfaction.

The programme started in Hamilton for over 65s with an acute illness and initially involved around 10 staff and 25 patients.

But high demand saw it eventually expand to Thames, Tokoroa, Te Kuiti, Taumaranui and Cambridge.

START grew even larger following a partnership between the DHB and ACC to include those who had sustained an injury and required non-acute rehabilitation.

It’s estimated the programme has helped around 10,000 people in their recovery since it began in 2010.

Up to 147 patients are in START’s care at any one time, which is the equivalent of six hospital wards or 25 percent of the entire adult ward capacity of Waikato Hospital.

On most days, START has the same or more patients than the region’s rural hospitals.

It has grown to more than 70 staff which help deliver the service across the Waikato DHB catchment area.

The START programme won two awards for Outstanding Innovation in 2017 and 2018 by the Health Round Table, a collective of Australasian health organisations.

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