Short Multi -disciplinary Acute Rehabilitation Team (SMART) to acute care

INTERVENTION: Provision of a multidisciplinary rehabilitation program consisting of rehabilitation medicine, occupational therapy and physiotherapy. Twice daily therapy with one group therapy session and one individual therapy session as well as three weekly case conferences to discuss the rehabilitation as well as discharge plan. Rehabilitation medicine component provides coordination and medical review of rehabilitation program for each patient. Daily group therapy session; duration 45‐60 minutes (dependent on the length of time patient takes to perform activities and number of patients in the group); maximum of 7 total sessions per patient. Facilitated by Occupational therapist (OT), Physiotherapist (PT) and allied health assistant (OT and PT are part of investigational team).The execution of the sessions is aided by an allied health assistant, who is not a member of the investigative team. Daily individual treatment sessions provided by PT in addition to the group session and OT intervention as indicated by individual patient needs. Duration 30minutes with a total 7 sessions per patient. Occupational Therapy provides assessment and treatment of deficits in activity performance and participation. Treatment is individualized to specific patient needs and may included such things as dressing retraining or energy conservation. Treatment includes an ADL activity practice component in the daily group therapy session. Physiotherapy provides assessment and treatment of of deficits in activity performance and participation. The treatment is individualized to specific patient needs but will include balance, strengthening and gait retraining during the group session. Individual treatment sessions are comprised of gait retraining, mobility assessment, stair practice and general strengthening. A individual exercise program is provided to each patient to perform independently. CONDITION: functional decline due to injury or illness PRIMARY OUTCOME: Length of stay in acute care as measured by hospital data system HIE, electronic patient record will be accessed to identify total length of stay for patient in acute ward . SECONDARY OUTCOME: Functional Improvement INCLUSION CRITERIA: Adult Inpatient in acute ward at RNSH Patients admitted under the care of a medical or surgical specialty Medically stable Having Identified rehab goals Willing to participate in program Provision of written informed consent Assessed to be suitable for discharge from hospital within 7 days