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St. John's Rehab Recognized as a Leading Practice for Optimizing Virtual Care in Outpatient Rehab

March 18, 2024

In the face of the global pandemic, the Outpatient (OP) department at St. John’s Rehab took bold steps to ensure continuity in patient care by implementing virtual care for stroke patients. As the world slowly returned to in-person appointments, the department didn't just abandon virtual care; instead, they embarked on a ground-breaking journey to make virtual care a permanent fixture in their toolkit, leading to their recent recognition as a Leading Practice for Optimizing Virtual Care in Outpatient Rehab by Health Standards Organization.

The initiative was founded on the principles of patient-centeredness, appropriateness, goal-based care, efficacy, efficiency, and best practices for virtual care. Drawing from resources like the Canadian Stroke Best Practices Recommendations for Virtual Care (2020) and the Toronto Rehab Telerehab Toolkit V1 (2020), the OP team created an infrastructure that not only bridged the immediate challenges posed by the pandemic but also enhanced the way outpatient rehabilitation is delivered.

A steering committee was formed, comprising the OP patient care manager, project manager, OT/PT/SLP professional practice leaders, a patient partner, and a Toronto Stroke Network (TSN) representative. This committee conducted an extensive review of best practices, available resources, and an environmental scan, with feedback sought from current patients and clinicians through online surveys and follow-up meetings. The neuro team mapped the current and future states of the program, identifying 14 improvement opportunities that were prioritized using an effort-impact matrix.

These improvement opportunities were then distributed among four interprofessional working groups, ensuring a holistic approach with patient representation. Patient engagement was a key focus, aligning with Health Quality Ontario’s Patient Engagement Framework.

Post-implementation, the impact on clinicians was significant. Surveys and structured research interviews revealed increased knowledge and satisfaction with VC tools, leading to a greater willingness to provide VC. Clinicians noted the potential of VC in addressing transportation challenges, involving family/caregivers in therapy sessions, and extending geographical reach to patients residing farther from the hospital.

Patients echoed these sentiments, highlighting the flexibility in scheduling, improved patient-oriented care, and the unique advantage of assessments within their home environment. VC became a catalyst for earlier access, enhanced patient-centeredness, interprofessional collaboration, and effective discharge planning.

The success of this initiative aligns seamlessly with St. John’s Rehab’s Strategic plan under the "Innovating Our Work" section. With virtual care infrastructure in place, St. John’s Rehab’s OP team has set a new standard for outpatient rehabilitation, ensuring that the benefits of virtual care are maximized to deliver efficient, patient-centered, and holistic rehabilitation services.