Background:
One of the barriers to timely transfer of patients from the acute stroke unit for inpatient rehabilitation (IPR) may be the time waiting for a formal rehabilitation physician review. The Greenlight initiative is a criteria-led method for staff to activate transfer without formal involvement from the receiving rehabilitation unit.
Aim:
We aimed to determine the length of stay (LOS) post greenlight and factors associated with longer wait for subacute transfer.
Methods:
A single centre retrospective analysis of all patients successfully transferred to IPR in 2023 at a high volume metropolitan primary stroke centre was conducted. Clinically significant events are defined as events that would normally require a transfer back to the acute facility such as new onset seizures, chest pain and aspiration pneumonia.
Results:
179 of the 316 patients transferred to IPR were referred via the greenlight pathway. Patients had a median age of 80 IQR (71,85), NIHSS of 5 IQR (3,9), a premorbid mRs of 1 IQR(1,3) and median LOS was 3 days IQR (1, 5) post greenlight with 27% of the patients waited one day or less and 15% waited for one week or more. 6.7% of patients had a clinically significant event prior to transfer. Haemorrhagic stroke (n=41) (β 2.2); 95% CI 1.055, 3.350; p<0.001) was associated with longer wait post greenlight in a multivariable regression model.
Conclusion:
Over half of all acute stroke patients transferred for IPR benefited from the greenlight pathway. Just over one quarter waited one day or less post activation.